Provider Demographics
NPI:1497499065
Name:CARABIO, BRYANN ALCANTARA (COTA/L)
Entity Type:Individual
Prefix:MR
First Name:BRYANN
Middle Name:ALCANTARA
Last Name:CARABIO
Suffix:
Gender:M
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 1:12 HILLVIEW TER
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-2305
Mailing Address - Country:US
Mailing Address - Phone:561-306-8488
Mailing Address - Fax:
Practice Address - Street 1:63 HOOYMAN DR
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3640
Practice Address - Country:US
Practice Address - Phone:973-495-0332
Practice Address - Fax:973-767-2871
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX216102224Z00000X
NJ46TA09101500224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant