Traci Marie O'Hara, D.P.T.

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

40QA00975000 Issued in NJ

Practice address

104 Chestnut St
Ridgewood, NJ 07450-2502

Phone

(201) 493-8111

NPI assigned

Sep 12, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189555200000",
    "number": "1912192055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 CHESTNUT ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074502502",
            "telephone_number": "201-493-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 CHESTNUT ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074502502",
            "telephone_number": "201-493-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'HARA",
        "first_name": "TRACI",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NJ",
            "license": "40QA00975000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PEOVIDER#",
            "identifier": "067570",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colette Nyajure, MD
• Kyaw Nyunt, MD
• Amanda Rose O'Brien Milleisen, PHD
• Linda O'Brien-Racine, LCSW
• Patrick Thomas O'Hara, L.C.S.W.
• Deirdre O'Malley, PSY.D.
• Patrick Michael O'Shaughnessy, DO
• Catherine Mary O'Sullivan, PSYD
• Obstetric & Gynecologic Associates of Ridgewood PA
• Jaclyn S Ocallaghan, LCSW

• Orthopedic Physical Therapist in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Orthopedic Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; 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.