Provider Demographics
NPI:1700292497
Name:MONTEMURRO, JEFFREY (MS, OTR/L, LMT, CKTP)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:MONTEMURRO
Suffix:
Gender:M
Credentials:MS, OTR/L, LMT, CKTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2445 S DELSEA DR
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-7000
Mailing Address - Country:US
Mailing Address - Phone:609-774-3378
Mailing Address - Fax:
Practice Address - Street 1:2445 S DELSEA DR
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-7000
Practice Address - Country:US
Practice Address - Phone:609-774-3378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00624800225X00000X
NJ18KT00966900225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist