Daniel James Mitchell, OTR

Individual provider Active NPI Occupational Therapist · Andover, NJ

NPI 1275809790 · NPPES record last updated Mar 7, 2015

Key facts

NPI
1275809790
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
46TR00174800 (NJ)
Practice address
99 Mulford Rd
Andover, NJ 07821-2600
Phone
(973) 383-6200
NPI assigned
Mar 29, 2012
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)
Yes

State licenses

LicenseStateTypeSpecialty
46TR00174800NJMDOccupational Therapist
OC-004588-LPAMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 46TR00174800 NJ Yes
Occupational Therapist 225X00000X OC-004588-L PA

Addresses

Primary practice location

99 Mulford Rd
Andover, NJ 07821-2600

Mailing address

164 West Shore Trail
Sparta, NJ 07871-1624
Phone (973) 729-8989

Other providers in Andover, NJ

All providers in Andover, NJ · Occupational Therapist in New Jersey

Sources for this page

Verify at the official NPI Registry.