Organization Active NPI

My Therapy Clubhouse

  • Pediatric Occupational Therapist
  • Passaic, NJ
National Provider Identifier
1215636014
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Legal business name
MY THERAPY CLUBHOUSE
Practice address
140 Brook Ave
Passaic, NJ 07055-4440
Phone
(732) 644-6643
NPI assigned
Mar 1, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Authorized official

Name
Faiga Hager, OTR/LNPI 1124785209
Title
Owner
Phone
(732) 644-6643

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X Primary

Addresses

Primary practice location

140 Brook Ave
Passaic, NJ 07055-4440

Mailing address

140 Brook Ave
Passaic, NJ 07055-4440
Phone (732) 644-6643

Other identifiers 2

IdentifierTypeStateIssuer
1124785209OtherINSURANCE
1124785209MedicaidNJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1677628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1215636014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 BROOK AVE",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070554440",
            "telephone_number": "732-644-6643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BROOK AVE",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070554440",
            "telephone_number": "732-644-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY THERAPY CLUBHOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A",
        "authorized_official_last_name": "HAGER",
        "authorized_official_first_name": "FAIGA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-644-6643",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE",
            "identifier": "1124785209",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124785209",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Passaic, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; 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.