Provider Demographics
NPI:1346924537
Name:MECHETTI, ANDREA (OT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:MECHETTI
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CORPORATE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-8736
Mailing Address - Country:US
Mailing Address - Phone:732-691-9854
Mailing Address - Fax:
Practice Address - Street 1:2035 LINCOLN HWY STE 1150
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-3351
Practice Address - Country:US
Practice Address - Phone:732-761-0302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00997000225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist