NPIMap

Organization Active NPI

Innovative Therapy Group

  • Early Intervention Provider Agency
  • Lakewood, NJ
National Provider Identifier
1972934115
Registry record updated Dec 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
INNOVATIVE THERAPY GROUP
Practice address
746 Park Ave
Lakewood, NJ 08701-2025
Phone
(732) 415-8990
NPI assigned
Dec 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2013

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

Authorized official

Name
Sam Sicker
Title
Owner
Phone
(723) 415-8990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

746 Park Ave
Lakewood, NJ 08701-2025

Mailing address

746 Park Ave
Lakewood, NJ 08701-2025

National Provider Directory

National Provider Directory
Tax ID family
Innovative Therapy Group4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386806400000",
    "number": "1972934115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "746 PARK AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087012025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "746 PARK AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087012025",
            "telephone_number": "732-415-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE THERAPY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-12",
        "last_updated": "2013-12-12",
        "status": "A",
        "authorized_official_last_name": "SICKER",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "723-415-8990"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; 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.