Provider Demographics
NPI:1386448884
Name:COLON, FERNANDO CARLOS (OTR/L)
Entity type:Individual
Prefix:MR
First Name:FERNANDO
Middle Name:CARLOS
Last Name:COLON
Suffix:
Gender:
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 1:3 ROYAL AVE
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-7323
Mailing Address - Country:US
Mailing Address - Phone:609-576-9774
Mailing Address - Fax:
Practice Address - Street 1:700 TOWN BANK RD
Practice Address - Street 2:
Practice Address - City:NORTH CAPE MAY
Practice Address - State:NJ
Practice Address - Zip Code:08204-4411
Practice Address - Country:US
Practice Address - Phone:609-898-8899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00772400225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist