Provider Demographics
NPI:1417592460
Name:SOCOLIUC, OANA (COTA/L)
Entity Type:Individual
Prefix:
First Name:OANA
Middle Name:
Last Name:SOCOLIUC
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 EDMUND AVE
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07502-1611
Mailing Address - Country:US
Mailing Address - Phone:856-462-9303
Mailing Address - Fax:
Practice Address - Street 1:49 MONTROSE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-2580
Practice Address - Country:US
Practice Address - Phone:718-473-3808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-14
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TA09183700224Z00000X
NY010343224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant