Provider Demographics
NPI:1023479300
Name:PORTA-ORAMAS, MARIA (OTR)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:PORTA-ORAMAS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 GLENDALE ST
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1219
Mailing Address - Country:US
Mailing Address - Phone:201-951-6756
Mailing Address - Fax:
Practice Address - Street 1:53 GLENDALE ST
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-1219
Practice Address - Country:US
Practice Address - Phone:201-951-6756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-14
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00292600225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist