Provider Demographics
NPI:1598078743
Name:TOLENTINO, MARIA EMELIA (OTR/L)
Entity Type:Individual
Prefix:
First Name:MARIA EMELIA
Middle Name:
Last Name:TOLENTINO
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 1:319 FORSGATE DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-1597
Mailing Address - Country:US
Mailing Address - Phone:732-521-4586
Mailing Address - Fax:732-521-4587
Practice Address - Street 1:319 FORSGATE DR.
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831
Practice Address - Country:US
Practice Address - Phone:732-521-4586
Practice Address - Fax:732-521-4587
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJTR00210400225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist