Provider Demographics
NPI:1538284757
Name:TOMPOROWSKI, ANDREA M (OTR/L)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:M
Last Name:TOMPOROWSKI
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 1:224 ARROWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-3174
Mailing Address - Country:US
Mailing Address - Phone:732-514-6578
Mailing Address - Fax:732-514-6579
Practice Address - Street 1:2005 US HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:BOUND BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08805-1523
Practice Address - Country:US
Practice Address - Phone:732-302-4596
Practice Address - Fax:732-302-4595
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00365300225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist