Healthcare Provider Details

I. General information

NPI: 1962250969
Provider Name (Legal Business Name): PLAYCONNECT PEDIATRIC THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2024
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 MONROE AVE
PARAMUS NJ
07652-4728
US

IV. Provider business mailing address

246 MONROE AVE
PARAMUS NJ
07652-4728
US

V. Phone/Fax

Practice location:
  • Phone: 201-390-8541
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: KAREN NEVAREZ
Title or Position: OWNER
Credential:
Phone: 201-390-8541