Provider Demographics
NPI:1174548846
Name:WEINMAN, ELLEN E (OT)
Entity type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:E
Last Name:WEINMAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:E
Other - Last Name:EICHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:150 FLORAL AVE
Mailing Address - Street 2:
Mailing Address - City:NEW PROVIDENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:07974-1557
Mailing Address - Country:US
Mailing Address - Phone:908-273-4300
Mailing Address - Fax:908-790-6576
Practice Address - Street 1:75 BLOOMFIELD AVENUE
Practice Address - Street 2:SUITE 102
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2735
Practice Address - Country:US
Practice Address - Phone:973-664-9899
Practice Address - Fax:973-664-1875
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00000100225XH1200X
PAOC009055225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ091929PMTMedicare ID - Type Unspecified