Provider Demographics
NPI:1821563792
Name:PERETZ, RIKKI (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:RIKKI
Middle Name:
Last Name:PERETZ
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 DAVIS RD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3146
Mailing Address - Country:US
Mailing Address - Phone:732-363-1992
Mailing Address - Fax:732-370-1973
Practice Address - Street 1:24 DAVIS RD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-3146
Practice Address - Country:US
Practice Address - Phone:732-363-1992
Practice Address - Fax:732-370-1973
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00267400225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist