Provider Demographics
NPI:1700198074
Name:ZAMORA, RAYMOND ROBLES (OTR)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:ROBLES
Last Name:ZAMORA
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 BLAUVELT ST
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-3811
Mailing Address - Country:US
Mailing Address - Phone:201-647-5654
Mailing Address - Fax:
Practice Address - Street 1:38 BLAUVELT ST
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-3811
Practice Address - Country:US
Practice Address - Phone:201-647-5654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-02
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14314225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics