Provider Demographics
NPI:1346434347
Name:MARDER, MARIA-THERESA J (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:MARIA-THERESA
Middle Name:J
Last Name:MARDER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 HARDWICK DR
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08638-2414
Mailing Address - Country:US
Mailing Address - Phone:609-530-9792
Mailing Address - Fax:
Practice Address - Street 1:53 WALTER ST
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08628-3016
Practice Address - Country:US
Practice Address - Phone:609-883-5391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-02
Last Update Date:2007-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00087300225X00000X
PAOC003501L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist