Active NPI
Mariola Magdalena Antolak, OTR/L
- Occupational Therapist
- West Orange, NJ
National Provider Identifier
1689192304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 46TR00792900
- Practice address
- 563 Northfield Ave
West Orange, NJ 07052-2426 - Phone
- (973) 243-2060
- NPI assigned
- Sep 1, 2017
- 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 | 46TR00792900 | NJ | Primary |
Addresses
Primary practice location
563 Northfield Ave
West Orange, NJ 07052-2426
Mailing address
563 Northfield Ave
West Orange, NJ 07052
Phone (973) 243-2060
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 |
|---|---|---|---|
| 46TR00792900 | NJ | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kessler Institute for Rehabilitation Inc | Past | Accepting new patients | |
| Kessler Institute for Rehabilitation, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rehabilitation Hospital
- West Orange, NJ
- NPI 1013919620
-
- Rehabilitation Hospital
- Marlton, NJ
- NPI 1528512266
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506124800000",
"number": "1689192304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "563 NORTHFIELD AVE",
"city": "WEST ORANGE",
"state": "NJ",
"postal_code": "07052",
"telephone_number": "973-243-2060",
"fax_number": "973-243-2387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "563 NORTHFIELD AVE",
"city": "WEST ORANGE",
"state": "NJ",
"postal_code": "070522426",
"telephone_number": "973-243-2060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTOLAK",
"first_name": "MARIOLA",
"middle_name": "MAGDALENA",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-01",
"last_updated": "2017-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NJ",
"license": "46TR00792900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Orange, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.