Ira Samantha Aglibut, OTR
Individual provider Active NPI Contractor · Nutley, NJ
NPI 1669914560 · NPPES record last updated Nov 8, 2016
Key facts
- NPI
- 1669914560
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- Practice address
- 57 E Centre St
Apt 1204
Nutley, NJ 07110-5410 - Phone
- (862) 220-0045
- NPI assigned
- Nov 8, 2016
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Yes |
Addresses
Primary practice location
57 E Centre St
Apt 1204
Nutley, NJ 07110-5410
Mailing address
57 E Centre St
Apt 1204
Nutley, NJ 07110-5410
Phone (862) 220-0045
Other providers in Nutley, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.