Jennifer Lyn Ekizian, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

46TR00407500 Issued in NJ

Practice address

590 Anderson Ave
Cliffside Park, NJ 07010-1721

Phone

(201) 941-8667

NPI assigned

Jan 6, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467500637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 ALEXANDER CT",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109545118",
            "telephone_number": "845-290-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 ANDERSON AVE",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070101721",
            "telephone_number": "201-941-8667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKIZIAN",
        "first_name": "JENNIFER",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00407500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Cliffside Park, NJ
• Providers in Cliffside Park, 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 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.