Healthcare Provider Details

I. General information

NPI: 1144132010
Provider Name (Legal Business Name): JACKELINE GISSELLE ARTILES OTD,OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JACKELINE GISSELLE ARTILES OTD, OTR/L

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

647 NJ-18 UNIT 1
EAST BRUNSWICK NJ
08816
US

IV. Provider business mailing address

14 JANCI CT
METUCHEN NJ
08840-2914
US

V. Phone/Fax

Practice location:
  • Phone: 732-256-1612
  • Fax:
Mailing address:
  • Phone: 848-203-4416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number46TR01299000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: