Jacquelyn Kuhn Provenzano, MOT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

46TR00610600 Issued in NJ

Practice address

579 Cranbury Rd Ste C
East Brunswick, NJ 08816-5405

Phone

(732) 432-0733

Fax

(732) 432-9131

NPI assigned

Jul 23, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ivyrehab Network Inc.

  • Physical Therapist
  • Hoboken, NJ
  • NPI 1174577274

  Occupational Therapist

  Medicare reassignment NPD
• Esd PT OT & SLP PLLC

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1003383308

  NJ, Occupational Therapist

  Medicare reassignment NPD
• Ivyrehab Network, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Cranford, NJ
  • NPI 1699590265

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1104499433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416495",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416495",
            "telephone_number": "631-580-5200",
            "fax_number": "631-580-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 CRANBURY RD STE C",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165405",
            "telephone_number": "732-432-0733",
            "fax_number": "732-432-9131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUHN PROVENZANO",
        "first_name": "JACQUELYN",
        "credential": "MOT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00610600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stanley M Kron, MD
• Susan Krum, AU.D, CCC-A
• KT Psychotherapy LLC
• Aleksander Kubiak, MD
• Sarah Kudron
• Alexander W Kulischenko, MD
• Idelma Kulischenko, MD
• Kumar & Kumar MD, LLC
• Ashali Kumar, MSW, LSW
• Ashok Kumar, M.D.

• Occupational Therapist in East Brunswick, NJ
• Providers in East Brunswick, 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 Jul 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.