Healthcare Provider Details

I. General information

NPI: 1306277009
Provider Name (Legal Business Name): RUSH OCCUPATIONAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2013
Last Update Date: 12/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 RIVER AVE
LAKEWOOD NJ
08701-5288
US

IV. Provider business mailing address

685 RIVER AVE
LAKEWOOD NJ
08701-5288
US

V. Phone/Fax

Practice location:
  • Phone: 732-364-3772
  • Fax:
Mailing address:
  • Phone: 732-364-3772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: RACHEL COHN
Title or Position: OCCUPATIONAL THERAPIST
Credential:
Phone: 732-364-3772