Provider Demographics
NPI:1487096293
Name:SIEVE, GRETA ROSE (OTR/L)
Entity type:Individual
Prefix:
First Name:GRETA
Middle Name:ROSE
Last Name:SIEVE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 BARBERRY CT
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-4819
Mailing Address - Country:US
Mailing Address - Phone:763-913-4407
Mailing Address - Fax:
Practice Address - Street 1:155 RAYMOND RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-9608
Practice Address - Country:US
Practice Address - Phone:732-329-1181
Practice Address - Fax:732-329-1171
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-22
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00619700314000000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility