Patra Vongsoasup

Individual provider Rehabilitation Hospital · NPI 1265839526

Patra Vongsoasup is an Occupational Therapist in Private Practice in Florham Park, New Jersey. Qualified in 2014, 12 years ago. Practices with Summit Medical Group PA, a 1,205-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying: 12
Licensed in: NJ
In the registry since: 2014
Specialties on file: 2

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Practice location Address checks out

140 Park Ave
Florham Park, NJ 07932-1049
Phone: (973) 404-9840

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

Additional practice locations (1)

95 Mount Kemble Ave, Morristown, NJ 07960-5155 — (201) 407-8340

Specialties & licences

Occupational Therapist (primary)	Taxonomy 225X00000X
Rehabilitation Hospital	Taxonomy 283X00000X · Licence 46TR00670500 (NJ)

Record details

NPI number	1265839526
Entity type	Individual (Type 1)
Gender	Female
Sole proprietor	Yes
NPI enumerated	December 1, 2014
Last updated in NPPES	March 2, 2022
Certification date	March 2, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialty	OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical school	OTHER
Graduated	2014 (12 years in practice)
Group practice	Summit Medical Group Pa — 1205 clinicians
Accepts Medicare assignment	Yes — accepts the Medicare-approved amount