Provider Demographics
NPI:1982179867
Name:PINHO, ANDREA (OTL)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:PINHO
Suffix:
Gender:F
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 OXFORD RD
Mailing Address - Street 2:
Mailing Address - City:COLONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07067-1014
Mailing Address - Country:US
Mailing Address - Phone:908-216-7549
Mailing Address - Fax:
Practice Address - Street 1:1935 LAKEWOOD RD STE 9
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-1211
Practice Address - Country:US
Practice Address - Phone:732-300-5911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00058300225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty