Provider Demographics
NPI:1013085794
Name:GIUFFRIDA, MICHAEL S (MA OTR)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:S
Last Name:GIUFFRIDA
Suffix:
Gender:M
Credentials:MA OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 HIGHFIELD LANE
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07009
Mailing Address - Country:US
Mailing Address - Phone:973-857-4171
Mailing Address - Fax:
Practice Address - Street 1:1373 BROAD STREET
Practice Address - Street 2:SUITE 302
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013
Practice Address - Country:US
Practice Address - Phone:973-773-4263
Practice Address - Fax:973-773-4336
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00314600225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist