Provider Demographics
NPI:1497914733
Name:MUTHERU, RACHEL (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:
Last Name:MUTHERU
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 FLORENCE PL
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407-3023
Mailing Address - Country:US
Mailing Address - Phone:917-224-4924
Mailing Address - Fax:201-703-2440
Practice Address - Street 1:35 FLORENCE PL
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07407-3023
Practice Address - Country:US
Practice Address - Phone:917-224-4924
Practice Address - Fax:201-703-2440
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00129300225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist