Jacqueline M. Severini, PT, MA

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA00638300 Issued in NJ

Practice address

2625 Morris Ave
Union, NJ 07083-5606

Phone

(908) 686-0840

Fax

(732) 855-9755

NPI assigned

Jul 4, 2006

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

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.

• Twin Boro Physical Therapy Associates PA

  • Physical Therapist
  • Clark, NJ
  • NPI 1811937527
  NPD
• Twin Boro Physical Therapy Associates, PA

  • Occupational Therapist
  • Newark, NJ
  • NPI 1659874857
  NPD

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1902836711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1014",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661014",
            "telephone_number": "973-855-9751",
            "fax_number": "973-855-9755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 MORRIS AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835606",
            "telephone_number": "908-686-0840",
            "fax_number": "732-855-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERINI",
        "first_name": "JACQUELINE",
        "middle_name": "M.",
        "credential": "PT, MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00638300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ilia Segal, MD
• Jessica Marie Sepulveda
• Steven Serafin
• Serenity Therapy Center LLC
• Isabel Serna
• Seymour M Gross DDS David a Maloff DMD PA
• Michael J Sgroi, CPO, LPO, PT
• Zainab Shabber
• Amit Shah, M.D.
• Nehaben Ketankumar Shah, M.D.

• Physical Therapist in Union, NJ
• Providers in Union, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; 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.