Pediatric Therapy Center of NJ LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

PEDIATRIC THERAPY CENTER OF NJ LLC

Practice address

912 Pompton Ave Ste B1
Cedar Grove, NJ 07009-1264

Phone

(973) 680-1971

NPI assigned

Apr 13, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carissa L Jannicelli Pampanin, OTRNPI 1336214154

Title

Director

Phone

(973) 865-9321

Specialties & licenses 2

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carissa L Jannicelli-Pampanin, OCCUPATIONAL THERAPI

  • Occupational Therapist
  • Cedar Grove, NJ
  • NPI 1336214154
  NPD Authorized official
• Deanna Marie Jannicelli Corby, MS, CCC-SLP

  • Speech-Language Pathologist
  • Cedar Grove, NJ
  • NPI 1598929127
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1083294003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 POMPTON AVE STE B1",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070091264",
            "telephone_number": "973-680-1971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 POMPTON AVE STE B1",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070091264",
            "telephone_number": "973-680-1971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC THERAPY CENTER OF NJ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-13",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "JANNICELLI PAMPANIN",
        "authorized_official_first_name": "CARISSA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "973-865-9321",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabel K Park, OTD, OTR/L
• Angelica Parmegiani, APN
• Dorothy A Pascale, D.M.D
• Ilesh Patel
• Manesh Paul
• Jeanice Pelaez, COTA/L
• Matthew James Peluso, D.M.D., M.S.
• Kayla R Perez, LAT, ATC
• Marcia Perez
• Maria Noreen Perez

• Occupational Therapist in Cedar Grove, NJ
• Providers in Cedar Grove, NJ by specialty
• Occupational Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.