Provider Demographics
NPI:1083487839
Name:GAVER, GEENA MARIE (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:GEENA
Middle Name:MARIE
Last Name:GAVER
Suffix:
Gender:
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:GEENA
Other - Middle Name:MARIE
Other - Last Name:SANTOMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTD, OTR/L
Mailing Address - Street 1:10 PINE ST APT 2H
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-4755
Mailing Address - Country:US
Mailing Address - Phone:973-714-9265
Mailing Address - Fax:
Practice Address - Street 1:21 PINE ST
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-3130
Practice Address - Country:US
Practice Address - Phone:973-586-8396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-02
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01154500225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist