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Contact Information

RANDAL S FEDORUK, OT
65 BERGEN ST
NEWARK, NJ07107-3001
 Phone: 973-972-0186
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

225XP0200X 67 Occupational Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for RANDAL S FEDORUK · (Male)

NPI Number 1437360575
Status Active
Credentials OT (Occupational Therapist)
Entity Individual
Enumeration date 05/24/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • NJ License # TR4600247500
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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