Provider Demographics
NPI:1891051835
Name:KING, PAMELA ANNE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:ANNE
Last Name:KING
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 1:1940 COMMERCE ST SUITE 210
Mailing Address - Street 2:PRIME REHABILITATION SERVICES, INC
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598
Mailing Address - Country:US
Mailing Address - Phone:914-631-9020
Mailing Address - Fax:914-631-9028
Practice Address - Street 1:1579 OLD FREEHOLD RD (NEW HAMPSHIRE AVE)
Practice Address - Street 2:ROSE GARDEN REHABILITATION & SNF
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755
Practice Address - Country:US
Practice Address - Phone:732-505-4477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00026800225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist