Active NPI
Gagandeep Dhaliwal, MOT
- Occupational Therapist
- Lake Hopatcong, NJ
National Provider Identifier
1699146282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 46TR00851800
- Practice address
- 757 Route 15 S
Suite 102
Lake Hopatcong, NJ 07849 - Phone
- (973) 860-0522
- Fax
- (973) 860-0523
- NPI assigned
- Oct 8, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 63 019683 | NY | |
| Occupational Therapist | 225X00000X | 46TR00851800 | NJ | Primary |
Addresses
Primary practice location
757 Route 15 S
Suite 102
Lake Hopatcong, NJ 07849
Mailing address
11 Eagle Rock Ave Ste 201
East Hanover, NJ 07936-3167
Phone (973) 887-9000
Other practice location 1
268 53rd St
Brooklyn, NY 11220-1717
Phone (248) 797-8284
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46TR00851800 | NJ | MD | Occupational Therapist |
| 63 019683 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sportscare Institute, Inc. | Past | Accepting new patients |
Interoperability endpoints
- gagandeep.dhaliwal.p2@direct.ucpnyc.nextgenshare.com
Organizations & group practices 1
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.
-
- Physical Therapist
- Toms River, NJ
- NPI 1275501074
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621382400000",
"number": "1699146282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 EAGLE ROCK AVE STE 201",
"city": "EAST HANOVER",
"state": "NJ",
"postal_code": "079363167",
"telephone_number": "973-887-9000",
"fax_number": "973-887-3816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "757 ROUTE 15 S",
"address_2": "SUITE 102",
"city": "LAKE HOPATCONG",
"state": "NJ",
"postal_code": "07849",
"telephone_number": "973-860-0522",
"fax_number": "973-860-0523"
}
],
"practiceLocations": [
{
"address_1": "268 53rd St",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112201717",
"country_code": "US",
"telephone_number": "248-797-8284",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DHALIWAL",
"first_name": "GAGANDEEP",
"credential": "MOT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-08",
"last_updated": "2021-05-19",
"certification_date": "2021-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "63 019683",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NJ",
"license": "46TR00851800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Hopatcong, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.