Healthcare Provider Details

I. General information

NPI: 1710784848
Provider Name (Legal Business Name): TESNEEM ABOUELMAGD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2025
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

739 LELAND AVE
PLAINFIELD NJ
07062-2140
US

IV. Provider business mailing address

5 HORIZON RD APT 207
FORT LEE NJ
07024-6627
US

V. Phone/Fax

Practice location:
  • Phone: 908-731-4210
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number46TR01224100
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: