Healthcare Provider Details

I. General information

NPI: 1073421855
Provider Name (Legal Business Name): PRINCETON OCCUPATIONAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 BUNN DR STE 101
PRINCETON NJ
08540-2800
US

IV. Provider business mailing address

130 WESTCOTT RD
PRINCETON NJ
08540-3062
US

V. Phone/Fax

Practice location:
  • Phone: 917-698-2118
  • Fax:
Mailing address:
  • Phone: 917-698-2118
  • 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: KATERINA KUCEROVA
Title or Position: OWNER/OT
Credential: MSOT
Phone: 917-698-2118