Healthcare Provider Details

I. General information

NPI: 1235969809
Provider Name (Legal Business Name): NIKA PIERRE-PAUL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 HUGHES ST
MAPLEWOOD NJ
07040-3303
US

IV. Provider business mailing address

45 HUGHES ST
MAPLEWOOD NJ
07040-3303
US

V. Phone/Fax

Practice location:
  • Phone: 862-246-4416
  • Fax:
Mailing address:
  • Phone: 862-246-4416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number46TR01257000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: