Provider Demographics
NPI:1508129800
Name:PIRUTINSKY, RAIZEL
Entity Type:Individual
Prefix:
First Name:RAIZEL
Middle Name:
Last Name:PIRUTINSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 RIVER AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5200
Mailing Address - Country:US
Mailing Address - Phone:732-833-3723
Mailing Address - Fax:888-247-4390
Practice Address - Street 1:761 RIVER AVE
Practice Address - Street 2:SUITE D
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5200
Practice Address - Country:US
Practice Address - Phone:732-833-3723
Practice Address - Fax:888-247-4390
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00503700225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist