Johnathan Matthew Anderson I

Individual provider Active NPI Occupational Therapy Assistant · East Greenwich, RI

NPI 1740030337 · NPPES record last updated Mar 25, 2024

Key facts

NPI
1740030337
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
OTA01335 (RI)
Practice address
2220 S County TRL
East Greenwich, RI 02818-1536
Phone
(401) 295-2955
NPI assigned
Mar 25, 2024
Sex
Male
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
OTA01335RIMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA01335 RI Yes

Addresses

Primary practice location

2220 S County TRL
East Greenwich, RI 02818-1536

Mailing address

3595 Post Rd Apt 23205
Warwick, RI 02886-7030

Other providers in East Greenwich, RI

All providers in East Greenwich, RI · Occupational Therapy Assistant in Rhode Island

Sources for this page

Verify at the official NPI Registry.