Provider Demographics
NPI:1992051528
Name:TRUXAL, VANESSA (OTR/L)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:TRUXAL
Suffix:
Gender:F
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 1:84 BORDEN ST
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4425
Mailing Address - Country:US
Mailing Address - Phone:585-749-3783
Mailing Address - Fax:
Practice Address - Street 1:2005 ROUTE 35 STE 21
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-2763
Practice Address - Country:US
Practice Address - Phone:732-663-9030
Practice Address - Fax:732-508-9317
Is Sole Proprietor?:No
Enumeration Date:2012-08-01
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015385225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics