Provider Demographics
NPI:1164632352
Name:WINTZ, PAULA (COTA)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:WINTZ
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 WINCHESTER CT
Mailing Address - Street 2:
Mailing Address - City:OCEAN VIEW
Mailing Address - State:NJ
Mailing Address - Zip Code:08230-1193
Mailing Address - Country:US
Mailing Address - Phone:609-407-0332
Mailing Address - Fax:609-407-0332
Practice Address - Street 1:235 DOLPHIN AVE
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-2015
Practice Address - Country:US
Practice Address - Phone:609-407-0332
Practice Address - Fax:609-407-0332
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TA09041000224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant