Active NPI
My Therapy Clubhouse
- Pediatric Occupational Therapist
- Passaic, NJ
National Provider Identifier
1215636014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Faiga Hager, OTR/L
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124785209 | Other | INSURANCE | |
| 1124785209 | Medicaid | NJ |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Occupational Therapist
- Passaic, NJ
- NPI 1124785209
-
- Occupational Therapist
- Passaic, NJ
- NPI 1952175440
-
- Speech-Language Pathologist
- Passaic, NJ
- NPI 1003625500
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.