Provider Demographics
NPI:1871850867
Name:AFRICA, LULETTE ANN (OT)
Entity Type:Individual
Prefix:MS
First Name:LULETTE
Middle Name:ANN
Last Name:AFRICA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 6TH ST APT 2L
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-2486
Mailing Address - Country:US
Mailing Address - Phone:908-316-4872
Mailing Address - Fax:
Practice Address - Street 1:246 CLIFTON AVE
Practice Address - Street 2:STE 5
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-1900
Practice Address - Country:US
Practice Address - Phone:862-899-7900
Practice Address - Fax:862-899-7901
Is Sole Proprietor?:No
Enumeration Date:2012-04-16
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00411400225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist