Professional Occupational & Physical Therapy, PLLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC

Practice address

14 Ridgedale Ave Ste 104
Cedar Knolls, NJ 07927-1106

Phone

(862) 430-4099

Fax

(862) 430-4091

NPI assigned

Nov 18, 2024

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

Manager of Credentialing

Phone

(631) 359-5805

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1548085335",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 RIDGEDALE AVE STE 104",
            "city": "CEDAR KNOLLS",
            "state": "NJ",
            "postal_code": "079271106",
            "telephone_number": "862-430-4099",
            "fax_number": "862-430-4091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-18",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "BRUSH",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "MANAGER OF CREDENTIALING",
        "authorized_official_telephone_number": "631-359-5805"
    },
    "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": []
}

• Meghan Kathleen Pillai, MD
• Jeffrey Pospis, LPC, LCADC, CCS
• Sarah Kelley Potash, M.D.
• Premier Pain and Rehabilitation Center of NJ PC
• Brianne L. Prior, D.C.
• Progressive Comprehensive Services LLC
• Progressive Comprehensive Services LLC
• Alexander Joseph Pronko
• Tomi T Prvulovic, MD
• Collin Purdy, PT

• Occupational Therapist in Cedar Knolls, NJ
• Providers in Cedar Knolls, 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 Nov 18, 2024; 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.