Provider Demographics
NPI:1467622464
Name:OUELLETTE, GEORGE WILLIAM
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:WILLIAM
Last Name:OUELLETTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 E ASBURY ANDERSON RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07882-4041
Mailing Address - Country:US
Mailing Address - Phone:908-689-7564
Mailing Address - Fax:
Practice Address - Street 1:72 E ASBURY ANDERSON RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07882-4041
Practice Address - Country:US
Practice Address - Phone:908-689-7564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist