Healthcare Provider Details

I. General information

NPI: 1366188633
Provider Name (Legal Business Name): TAYLOR PANDORF OT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2022
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 CARNEGIE PLZ
CHERRY HILL NJ
08003-1000
US

IV. Provider business mailing address

7 CARNEGIE PLZ
CHERRY HILL NJ
08003-1000
US

V. Phone/Fax

Practice location:
  • Phone: 877-407-3422
  • Fax:
Mailing address:
  • Phone: 877-407-3422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number46TR01296300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number46TA09178100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: