Provider Demographics
NPI:1477132298
Name:KOERNER, EMILY (OT/R)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:KOERNER
Suffix:
Gender:F
Credentials:OT/R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1447 ROUTE 18 STE 3
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-3797
Mailing Address - Country:US
Mailing Address - Phone:732-727-7333
Mailing Address - Fax:732-908-1026
Practice Address - Street 1:1447 ROUTE 18 STE 3
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-3797
Practice Address - Country:US
Practice Address - Phone:732-727-7333
Practice Address - Fax:732-908-1026
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00972800225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand