Healthcare Provider Details

I. General information

NPI: 1336990829
Provider Name (Legal Business Name): TAYLOR PSIROGIANES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2024
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 GODWIN AVE
RIDGEWOOD NJ
07450-3739
US

IV. Provider business mailing address

782 FRANKLIN LAKE RD
FRANKLIN LAKES NJ
07417-2276
US

V. Phone/Fax

Practice location:
  • Phone: 201-414-0144
  • Fax:
Mailing address:
  • Phone: 201-414-0144
  • 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:
Title or Position:
Credential:
Phone: