Provider Demographics
NPI:1396989075
Name:DELMONICO, ANDREA ROSE (MS, OTR/L)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:ROSE
Last Name:DELMONICO
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:700 GODWIN AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1444
Mailing Address - Country:US
Mailing Address - Phone:201-447-0303
Mailing Address - Fax:
Practice Address - Street 1:700 GODWIN AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432-1444
Practice Address - Country:US
Practice Address - Phone:201-447-0303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00411900225XN1300X, 225XP0200X, 225XP0019X, 225XG0600X
NY014561-1225XP0200X, 225XN1300X, 225XP0019X, 225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology