Jackeline Quiroz

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

46TR01083700 Issued in NJ

Practice address

111 Dean Dr # 1N
Tenafly, NJ 07670-2764

Phone

(201) 503-7173

NPI assigned

Sep 28, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Flow Home Care Physical Therapy LLC

  • Physical Therapist
  • Oakland, NJ
  • NPI 1881574390
  Medicare reassignment NPD
• Cornerstone Medical Procedures LLC

  • Medical Specialty Clinic/Center
  • Riverdale, NJ
  • NPI 1205509460
  NPD (past)

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

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1780308296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 LEONARD TER",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074703337",
            "telephone_number": "973-870-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DEAN DR # 1N",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076702764",
            "telephone_number": "201-503-7173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIROZ",
        "first_name": "JACKELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-28",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR01083700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PS Medical LLC
• PS Medical PLLC
• Psychiatric Care Professional Association
• Gail Quackenbush, M.D.
• Kyla Isabelle M Quintos
• R del Priore DDS PA
• Netta Raz Shachar
• Kajsa Reaves, LMHC
• Ilene Michelle Refkin
• Vivian Reich, SPEECH THERAPIST

• Occupational Therapist in Tenafly, NJ
• Providers in Tenafly, 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 Sep 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.