Healthcare Provider Details

I. General information

NPI: 1932525649
Provider Name (Legal Business Name): RENA KAPLAN OT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2014
Last Update Date: 09/20/2021
Certification Date: 09/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 RAVEN LN
LAKEWOOD NJ
08701-4968
US

IV. Provider business mailing address

1 RAVEN LN
LAKEWOOD NJ
08701-4965
US

V. Phone/Fax

Practice location:
  • Phone: 732-534-0091
  • Fax:
Mailing address:
  • Phone: 732-534-0091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number46TR00546300
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number46TR00546300
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number46TR00546300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: