Healthcare Provider Details

I. General information

NPI: 1871011643
Provider Name (Legal Business Name): CLAUDIA OKULICZ PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 CLIFTON AVE
CLIFTON NJ
07013-3518
US

IV. Provider business mailing address

1377 MOTOR PKWY STE 307
ISLANDIA NY
11749-5258
US

V. Phone/Fax

Practice location:
  • Phone: 973-778-1134
  • Fax: 973-614-1530
Mailing address:
  • Phone: 631-580-5200
  • Fax: 973-928-3589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA01743400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: