Provider Demographics
NPI:1427195635
Name:SALAZAR, GILBERT JOSEPH (OTR)
Entity Type:Individual
Prefix:MR
First Name:GILBERT
Middle Name:JOSEPH
Last Name:SALAZAR
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 STATE ROUTE 36
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS
Mailing Address - State:NJ
Mailing Address - Zip Code:07732-1607
Mailing Address - Country:US
Mailing Address - Phone:732-708-1449
Mailing Address - Fax:732-708-1449
Practice Address - Street 1:3910 PARK AVE STE 3
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3062
Practice Address - Country:US
Practice Address - Phone:732-549-2030
Practice Address - Fax:732-549-5549
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00133400225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist