Provider Demographics
NPI:1619215472
Name:BERGER, RACHEL AHUVA (OTR/L)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:AHUVA
Last Name:BERGER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:AHUVA
Other - Last Name:LIEBERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 RIVER AVE
Mailing Address - Street 2:SUITE 245
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4738
Mailing Address - Country:US
Mailing Address - Phone:732-367-1888
Mailing Address - Fax:732-367-5910
Practice Address - Street 1:500 RIVER AVE
Practice Address - Street 2:SUITE 245
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4738
Practice Address - Country:US
Practice Address - Phone:732-367-1888
Practice Address - Fax:732-367-5910
Is Sole Proprietor?:No
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00563200225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist