Basic Information
| Provider Information | |||||||||
| NPI: | 1073850343 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FOX REHAB OT MD LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7 CARNEGIE PLZ | ||||||||
| Address2: | |||||||||
| City: | CHERRY HILL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080031000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8774073422 | ||||||||
| FaxNumber: | 8774074329 | ||||||||
| Practice Location | |||||||||
| Address1: | 2205 YORK RD | ||||||||
| Address2: | |||||||||
| City: | TIMONIUM | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210933163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8774073422 | ||||||||
| FaxNumber: | 8774074329 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/07/2013 | ||||||||
| LastUpdateDate: | 06/11/2013 | ||||||||
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| AuthorizedOfficialLastName: | LEGATO | ||||||||
| AuthorizedOfficialFirstName: | FELICIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | MS, OTR/L | ||||||||
| AuthorizedOfficialTelephone: | 8774073422 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MS, OTR/L | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | MD | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.