Basic Information
| Provider Information | |||||||||
| NPI: | 1124675335 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARSICH | ||||||||
| FirstName: | BRIANA | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 108 LAURELWOOD CT | ||||||||
| Address2: | |||||||||
| City: | ROCKAWAY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 078662250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9738656561 | ||||||||
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| Practice Location | |||||||||
| Address1: | 65 NORTH SUSSES STREET | ||||||||
| Address2: | |||||||||
| City: | DOVER | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9733615200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2019 | ||||||||
| LastUpdateDate: | 08/22/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 46TR00880300 | NJ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.