Individual provider Active NPI

Helene Tornick Bruch, OTRL

  • Occupational Therapist
  • Fanwood, NJ
National Provider Identifier
1417178237
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
00TR000406 Issued in NJ
Practice address
67 Montrose Ave
Fanwood, NJ 07023-1108
Phone
(908) 889-7709
Fax
(908) 889-7709
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 00TR000406 NJ Primary

Addresses

Primary practice location

67 Montrose Ave
Fanwood, NJ 07023-1108

Mailing address

67 Montrose Ave
Fanwood, NJ 07023-1108
Phone (908) 889-7709

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
00TR000406NJMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417178237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 MONTROSE AVE",
            "city": "FANWOOD",
            "state": "NJ",
            "postal_code": "070231108",
            "telephone_number": "908-889-7709",
            "fax_number": "908-889-7709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 MONTROSE AVE",
            "city": "FANWOOD",
            "state": "NJ",
            "postal_code": "070231108",
            "telephone_number": "908-889-7709",
            "fax_number": "908-889-7709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCH",
        "first_name": "HELENE",
        "middle_name": "TORNICK",
        "name_prefix": "Ms.",
        "credential": "OTRL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "00TR000406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fanwood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.