Provider Demographics
NPI:1356702005
Name:TISCHER, STEPHANIE M (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:M
Last Name:TISCHER
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 1:2500 RDIGEWOOD ROAD
Mailing Address - Street 2:
Mailing Address - City:WALL
Mailing Address - State:NJ
Mailing Address - Zip Code:07719
Mailing Address - Country:US
Mailing Address - Phone:732-528-9311
Mailing Address - Fax:
Practice Address - Street 1:801 TILTON RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1265
Practice Address - Country:US
Practice Address - Phone:609-645-0505
Practice Address - Fax:609-641-3532
Is Sole Proprietor?:No
Enumeration Date:2016-03-09
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00707400225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist