Provider Demographics
NPI:1477277028
Name:PRIETO VILLARRAGA, ALVARO ROBINSON (OTA)
Entity Type:Individual
Prefix:
First Name:ALVARO
Middle Name:ROBINSON
Last Name:PRIETO VILLARRAGA
Suffix:
Gender:M
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 FRANK W BURR BLVD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-6728
Mailing Address - Country:US
Mailing Address - Phone:551-449-0135
Mailing Address - Fax:
Practice Address - Street 1:200 FRANK W BURR BLVD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-6728
Practice Address - Country:US
Practice Address - Phone:551-449-0135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-28
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports