Healthcare Provider Details

I. General information

NPI: 1194401554
Provider Name (Legal Business Name): TINY TREASURES THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2023
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 WILLOWBROOK BLVD STE 110 #3514
WAYNE NJ
07470
US

IV. Provider business mailing address

155 WILLOWBROOK BLVD STE 110 #3514
WAYNE NJ
07470
US

V. Phone/Fax

Practice location:
  • Phone: 732-997-7381
  • Fax:
Mailing address:
  • Phone: 732-997-7381
  • 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: URMILA MANE
Title or Position: PEDIATRIC OCCUPATIONAL THERAPIST
Credential: MS, OTR/L
Phone: 732-997-7381