Provider Demographics
NPI:1427767508
Name:WOERSCHING, BLAIR
Entity type:Individual
Prefix:
First Name:BLAIR
Middle Name:
Last Name:WOERSCHING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 HOMESTEAD DR
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-4613
Mailing Address - Country:US
Mailing Address - Phone:973-534-8765
Mailing Address - Fax:
Practice Address - Street 1:917 HOMESTEAD DR
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-4613
Practice Address - Country:US
Practice Address - Phone:973-534-8765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01041800225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ46TR01041800OtherOCCUPATIONAL THERAPY LICENSE