Provider Demographics
NPI:1508698176
Name:FREUND, EVELYN CHAVA (COTA/L)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:CHAVA
Last Name:FREUND
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:CHAVI
Other - Middle Name:
Other - Last Name:MUSCHEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:COTA/L
Mailing Address - Street 1:43 KNIGHTSBRIDGE PL
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-1271
Mailing Address - Country:US
Mailing Address - Phone:732-523-0455
Mailing Address - Fax:
Practice Address - Street 1:1950 RUTGERS UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4537
Practice Address - Country:US
Practice Address - Phone:732-554-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TA09125300224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant