Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Edwin Rafael Fernandez Grullon

Individual provider Occupational Therapy Assistant · NPI 1912469321

Edwin Rafael Fernandez Grullon is an Occupational Therapy Assistant in Bayonne, New Jersey. Licensed in New Jersey. Registered with an NPI since 2019.

Licensed in
NJ
In the registry since
2019

Practice location Address checks out

47 Bayside Dr
Bayonne, NJ 07002-1278
Phone: (239) 298-6665
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 46TA09163500 (NJ)

Record details

NPI number1912469321
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 3, 2019
Last updated in NPPESApril 4, 2019

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