Provider Demographics
NPI:1386339497
Name:ROBERTELLO, JAMES FIORE JR (OTR/L)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:FIORE
Last Name:ROBERTELLO
Suffix:JR
Gender:M
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 1:14 NORTHRIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-5332
Mailing Address - Country:US
Mailing Address - Phone:908-967-1383
Mailing Address - Fax:
Practice Address - Street 1:14 NORTHRIDGE WAY
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5332
Practice Address - Country:US
Practice Address - Phone:908-967-1383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01115400225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist