Provider Demographics
NPI:1235650623
Name:GORTON, LAUREN (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:GORTON
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 KENSINGTON CT UNIT 2
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-3975
Mailing Address - Country:US
Mailing Address - Phone:201-317-3833
Mailing Address - Fax:
Practice Address - Street 1:300 CORPORATE CENTER DR
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8736
Practice Address - Country:US
Practice Address - Phone:732-761-0088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-06
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00324800225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics