Professional Occupational & Physical Therapy, PLLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC

Practice address

566 Route 23
Pompton Plains, NJ 07444-1420

Phone

(862) 248-0140

Fax

(862) 248-0141

NPI assigned

Oct 7, 2016

Organization subpart

No

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

Authorized official

Name

Kathleen Brush

Title

Credentialing Manager

Phone

(718) 819-6805

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

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

{
    "created_epoch": "1475798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1346790847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5859",
            "fax_number": "631-396-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "566 ROUTE 23",
            "city": "POMPTON PLAINS",
            "state": "NJ",
            "postal_code": "074441420",
            "telephone_number": "862-248-0140",
            "fax_number": "862-248-0141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-07",
        "last_updated": "2018-03-29",
        "status": "A",
        "authorized_official_last_name": "BRUSH",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "718-819-6805"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrienne Margaret Popovich, LCSW, MSW
• Steven Darren Potter, M.D.
• Gwen A Pra, MHA, OTR/L
• Pro Vision Physical Therapy
• Procare Medical Transportation Corp
• Professional Orthopedic and Sports Physical Therapy of NJ, LLC
• Promenade Eye Care, P.a.
• Thalia K Psillakis, DMD
• Nicoletta Francesca Quitadamo, DNP, FNP-BC
• R.S.C. Counseling, LLC

• Occupational Therapist in Pompton Plains, NJ
• Providers in Pompton Plains, NJ by specialty
• Occupational Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.