Provider Demographics
NPI:1386422905
Name:DELA CRUZ, RONALD KEVIN (OTR/L)
Entity type:Individual
Prefix:
First Name:RONALD KEVIN
Middle Name:
Last Name:DELA CRUZ
Suffix:
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 1:73 KINGFISHER CT
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-2504
Mailing Address - Country:US
Mailing Address - Phone:732-754-5346
Mailing Address - Fax:
Practice Address - Street 1:766 BROAD ST
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4203
Practice Address - Country:US
Practice Address - Phone:855-428-8246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01133100225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist