Provider Demographics
NPI:1649617010
Name:NIERENBERG, ANNA (BS)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:NIERENBERG
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CHEROKEE PATH
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-5482
Mailing Address - Country:US
Mailing Address - Phone:908-227-2995
Mailing Address - Fax:
Practice Address - Street 1:1 CHEROKEE PATH
Practice Address - Street 2:
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876-5482
Practice Address - Country:US
Practice Address - Phone:908-227-2995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-26
Last Update Date:2013-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00051800225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist