Provider Demographics
NPI:1881790814
Name:OLLER, DARIA MARIE (PT, ATC)
Entity type:Individual
Prefix:DR
First Name:DARIA
Middle Name:MARIE
Last Name:OLLER
Suffix:
Gender:F
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 S VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07035-2425
Mailing Address - Country:US
Mailing Address - Phone:201-638-1642
Mailing Address - Fax:
Practice Address - Street 1:22 S VALLEY RD
Practice Address - Street 2:
Practice Address - City:LINCOLN PARK
Practice Address - State:NJ
Practice Address - Zip Code:07035-2425
Practice Address - Country:US
Practice Address - Phone:201-638-1642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT020848225100000X
NJ25MT001389002255A2300X
NJ40QA01603700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer