Professional Occupational & Physical Therapy, PLLC
Organization Active NPI Occupational Therapist · Haskell, NJ
NPI 1639629116 · NPPES record last updated Mar 29, 2018
Key facts
- NPI
- 1639629116
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Occupational Therapist 225X00000X
- Legal business name
- PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC
- Practice address
- 1069 Ringwood Ave
Haskell, NJ 07420-1408 - Phone
- (973) 616-9700
- Fax
- (973) 616-9760
- NPI assigned
- Oct 10, 2016
- Organization subpart
- No
Authorized official
- Name
- Kathleen Brush
- Title
- Credentialing Manager
- Phone
- (631) 359-5859
Practitioners 2
-
Julianne Roccuzzo, PT, DPT
-
Gary Allan Shiffman, P.T.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170118000654 | NJ | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 3779873401 |
Receives reassigned benefits from 296 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | |||
| Occupational Therapist |
225X00000X | Yes |
Addresses
Primary practice location
1069 Ringwood Ave
Haskell, NJ 07420-1408
Mailing address
576 Broadhollow Rd
Melville, NY 11747-5002
Phone (631) 359-5859
Other providers in Haskell, NJ
- Ann L Pinon
- Ashleigh Pomponio
- Vedant Mukund Prajapati
- Peggy Ann Prekopa
- Premier Counseling Care
- Professional Orthopedic and Sports Physical Therapy of NJ, LLC
- R & D Health Management, Inc
- Jennifer Leigh Rana
- Derk Miles Replogle
- Stephanie Ricciardi
All providers in Haskell, NJ · Occupational Therapist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.