Dane Eric Burch, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Ridgefield, NJ

NPI 1114845302 · NPPES record last updated Jul 7, 2026

Key facts

NPI
1114845302
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
46TA09256600 (NJ)
Practice address
761 Shetland LN
Ridgefield, NJ 07657-1239
Phone
(201) 566-8974
NPI assigned
Jul 7, 2026
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant
Group: 193400000X SINGLE SPECIALTY GROUP
224Z00000X 46TA09256600 NJ Yes

Addresses

Primary practice location

761 Shetland LN
Ridgefield, NJ 07657-1239

Mailing address

761 Shetland LN
Ridgefield, NJ 07657-1239
Phone (201) 566-8974

Other providers in Ridgefield, NJ

All providers in Ridgefield, NJ · Occupational Therapy Assistant in New Jersey

Sources for this page

Verify at the official NPI Registry.