Healthcare Provider Details

I. General information

NPI: 1922704931
Provider Name (Legal Business Name): TARYN EILEEN HUB OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TARYN EILEEN FINK

II. Dates (important events)

Enumeration Date: 02/01/2023
Last Update Date: 02/01/2023
Certification Date: 02/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 RIVER AVE
LAKEWOOD NJ
08701-5227
US

IV. Provider business mailing address

531 SMITH DR
POINT PLEASANT BORO NJ
08742-5429
US

V. Phone/Fax

Practice location:
  • Phone: 732-367-1133
  • Fax: 732-370-1087
Mailing address:
  • Phone: 732-403-6573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number46TR00598700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: