Alysa Ruback, OTR

Individual provider Active NPI Occupational Therapist · Rivervale, NJ

NPI 1134498918 · NPPES record last updated Dec 22, 2011

Key facts

NPI
1134498918
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
005733-1 (NY)
Practice address
607 Dale CT W
Rivervale, NJ 07675-5908
Phone
(201) 456-2577
NPI assigned
Dec 22, 2011
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
005733-1NYMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 005733-1 NY Yes

Addresses

Primary practice location

607 Dale CT W
Rivervale, NJ 07675-5908

Mailing address

607 Dale CT W
Rivervale, NJ 07675-5908

Other providers in Rivervale, NJ

All providers in Rivervale, NJ · Occupational Therapist in New Jersey

Sources for this page

Verify at the official NPI Registry.