Provider Demographics
NPI:1205186665
Name:MARTI, RANDY F (MAED, MSOTR)
Entity type:Individual
Prefix:MR
First Name:RANDY
Middle Name:F
Last Name:MARTI
Suffix:
Gender:M
Credentials:MAED, MSOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 MICROLAB RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-1623
Mailing Address - Country:US
Mailing Address - Phone:973-992-8181
Mailing Address - Fax:973-992-9797
Practice Address - Street 1:15 MICROLAB RD
Practice Address - Street 2:SUITE 101
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-1623
Practice Address - Country:US
Practice Address - Phone:973-992-8181
Practice Address - Fax:973-992-9797
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00344900225XN1300X
PAOC012406225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation