Active NPI
Isabel K Park, OTD, OTR/L
- Occupational Therapist
- Cedar Grove, NJ
National Provider Identifier
1629673264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 46TR00958700
- Practice address
- 165A Tierney Dr
Cedar Grove, NJ 07009-1956 - Phone
- (201) 463-6003
- NPI assigned
- Dec 2, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 46TR00958700 | NJ | Primary |
Addresses
Primary practice location
165A Tierney Dr
Cedar Grove, NJ 07009-1956
Mailing address
165A Tierney Dr
Cedar Grove, NJ 07009-1956
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46TR00958700 | NJ | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606867200000",
"number": "1629673264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "165A TIERNEY DR",
"city": "CEDAR GROVE",
"state": "NJ",
"postal_code": "070091956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "165A TIERNEY DR",
"city": "CEDAR GROVE",
"state": "NJ",
"postal_code": "070091956",
"telephone_number": "201-463-6003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "ISABEL",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "OTD, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-02",
"last_updated": "2020-12-02",
"certification_date": "2020-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NJ",
"license": "46TR00958700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedar Grove, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.