Provider Demographics
NPI:1689868549
Name:FALLER, PATRICIA A (OTR/L)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:FALLER
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 1:94 STEVENS RD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-1237
Mailing Address - Country:US
Mailing Address - Phone:732-914-1100
Mailing Address - Fax:732-797-3830
Practice Address - Street 1:94 STEVENS RD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-1237
Practice Address - Country:US
Practice Address - Phone:732-914-1100
Practice Address - Fax:732-797-3830
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TROOO33500225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics