Provider Demographics
NPI:1285055632
Name:WEINER, ALISON (OTR/L)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:WEINER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 WHITE CEDAR BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-6555
Mailing Address - Country:US
Mailing Address - Phone:551-497-2100
Mailing Address - Fax:
Practice Address - Street 1:2185 LEMOINE AVE
Practice Address - Street 2:APT 7M
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-6036
Practice Address - Country:US
Practice Address - Phone:551-497-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-01
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10882225X00000X
NH2411225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist