Pro Staff Dynamic Hand Therapy, Inc.

Primary specialty

Hand Occupational TherapistTaxonomy code 225XH1200X

License

46TR00508400 Issued in NJ

Legal business name

PRO STAFF DYNAMIC HAND THERAPY, INC.

Practice address

49 Claremont Ave
Suite 5
Montclair, NJ 07042-4854

Phone

(973) 680-8390

Fax

(973) 680-8391

NPI assigned

Jan 22, 2014

Last updated

May 29, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Jaclyn Ann Kopidlowski, MS, OTR/L, CHTNPI 1497056485

Title

Owner

Phone

(973) 766-3523

Specialties & licenses 6

Addresses

Other names 1

• Pro Staff Rehab & Wellness, Inc. Former legal business name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jaclyn Ann Kopidlowski, MS, OTR/L

  • Hand Occupational Therapist
  • Nutley, NJ
  • NPI 1497056485
  Authorized official Same address or phone
• Carlos A Ospina

  • Physical Therapist
  • Nutley, NJ
  • NPI 1891028429
  NPD

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

{
    "created_epoch": "1390348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432857600000",
    "number": "1871916130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 FRANKLIN AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071102712",
            "telephone_number": "973-680-8390",
            "fax_number": "973-680-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 CLAREMONT AVE",
            "address_2": "SUITE 5",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424854",
            "telephone_number": "973-680-8390",
            "fax_number": "973-680-8391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO STAFF DYNAMIC HAND THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-22",
        "last_updated": "2015-05-29",
        "status": "A",
        "authorized_official_last_name": "KOPIDLOWSKI",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-766-3523",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "MS, OTR/L, CHT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0404X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Cardiac Facilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "NJ",
            "license": "46TR00508400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pro Staff Rehab & Wellness, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Hand Occupational Therapist in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Hand Occupational Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.