Blossoms Pediatric Occupational Therapy LLC.

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

46TR00378600 Issued in NJ

Legal business name

BLOSSOMS PEDIATRIC OCCUPATIONAL THERAPY LLC.

Practice address

1501 Hamburg Turnpike
Suite 305
Wayne, NJ 07470

Phone

(973) 832-7266

Fax

(973) 694-3201

NPI assigned

Mar 16, 2014

Last updated

Jul 21, 2022By 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

Kathleen Brandt, MA, OTR/L

Title

Owner

Phone

(973) 832-7266

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Emily Dequinzio, MS, OTR/L

  • Occupational Therapist
  • Wayne, NJ
  • NPI 1003479981
  NPD (past)

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

{
    "created_epoch": "1394928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1992121818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 HAMBURG TURNPIKE",
            "address_2": "SUITE 305",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "07470",
            "telephone_number": "973-832-7266",
            "fax_number": "973-694-3201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 HAMBURG TURNPIKE",
            "address_2": "SUITE 305",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "07470",
            "telephone_number": "973-832-7266",
            "fax_number": "973-694-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOMS PEDIATRIC OCCUPATIONAL THERAPY LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-16",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BRANDT",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-832-7266",
        "authorized_official_credential": "MA, OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NJ",
            "license": "46TR00378600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Carol Blau, DMD
• Robert Howard Bleicher, M.D.
• Lawrence Blitz, MD
• Rebecca Bloom, LAC
• Blossom Bebes LLC
• Kayla Marie Blumetti, LMSW
• Matias Blumetti, APN
• Bryan Bocco, APN
• Lauren Jane Bodker, M.S OTR
• Aneta Bodyziak, DPT

• Pediatric Occupational Therapist in Wayne, NJ
• Providers in Wayne, NJ by specialty
• Pediatric Occupational Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.