Provider Demographics
NPI:1710219175
Name:AUSTIN, MARTHA DUARTE (OTR/L)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:DUARTE
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:272 SUNSET KY
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-2213
Mailing Address - Country:US
Mailing Address - Phone:917-582-5455
Mailing Address - Fax:201-656-8801
Practice Address - Street 1:720 MONROE ST
Practice Address - Street 2:C408
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-6315
Practice Address - Country:US
Practice Address - Phone:201-656-8800
Practice Address - Fax:201-656-8801
Is Sole Proprietor?:No
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ46TR00231100225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist