Provider Demographics
NPI:1841493624
Name:BEITER, CARRIE S (OTR)
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:S
Last Name:BEITER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 ALBERT PL
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-5309
Mailing Address - Country:US
Mailing Address - Phone:201-445-1613
Mailing Address - Fax:
Practice Address - Street 1:330 MAIN ST
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2238
Practice Address - Country:US
Practice Address - Phone:973-635-0202
Practice Address - Fax:973-635-9609
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00045000225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist