Active NPI
Devora Jacabson Grohman
- Student in an Organized Health Care Education/Training Program
- Lakewood, NJ
National Provider Identifier
1134432123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- G7528165005882
- Practice address
- 15 Rose Park Cres
Lakewood, NJ 08701-4867 - Phone
- (732) 833-3723
- Fax
- (888) 247-4390
- NPI assigned
- Jul 19, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | G7528165005882 | NJ | Primary |
| Occupational Therapist | 225X00000X | 016799 | NY |
Addresses
Primary practice location
15 Rose Park Cres
Lakewood, NJ 08701-4867
Mailing address
15 Rose Park Cres
Lakewood, NJ 08701-4867
Phone (732) 833-3723
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016799 | NY | MD | Occupational Therapist |
| G7528165005882 | NJ | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378684800000",
"number": "1134432123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 ROSE PARK CRES",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087014867",
"telephone_number": "732-833-3723",
"fax_number": "888-247-4390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 ROSE PARK CRES",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087014867",
"telephone_number": "732-833-3723",
"fax_number": "888-247-4390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACABSON GROHMAN",
"first_name": "DEVORA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-19",
"last_updated": "2013-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NJ",
"license": "G7528165005882",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "016799",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.