Healthcare Provider Details

I. General information

NPI: 1942914536
Provider Name (Legal Business Name): SARAH ELIZABETH GROGAN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH ELIZABETH MILLER

II. Dates (important events)

Enumeration Date: 01/09/2023
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 PROSPER WAY UNIT 11-12
BRICK NJ
08723-3539
US

IV. Provider business mailing address

909 CLAYTON AVE
POINT PLEASANT BORO NJ
08742-2932
US

V. Phone/Fax

Practice location:
  • Phone: 732-210-0805
  • Fax:
Mailing address:
  • Phone: 732-674-6193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number46TR01051400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: