Provider Demographics
NPI:1316082514
Name:OAK, POOJA P (OTR L CHT)
Entity type:Individual
Prefix:MRS
First Name:POOJA
Middle Name:P
Last Name:OAK
Suffix:
Gender:F
Credentials:OTR L CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3120 PRINCETON PIKE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2325
Mailing Address - Country:US
Mailing Address - Phone:609-896-0444
Mailing Address - Fax:609-587-4349
Practice Address - Street 1:3120 PRINCETON PIKE
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2325
Practice Address - Country:US
Practice Address - Phone:609-896-0444
Practice Address - Fax:609-587-4349
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4068225X00000X
NJ46TR00668600225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist