Healthcare Provider Details

I. General information

NPI: 1952040594
Provider Name (Legal Business Name): SENSORY THERAPEUTICS OF NJ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2022
Last Update Date: 06/01/2022
Certification Date: 06/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1129 BLOOMFIELD AVE STE 210
WEST CALDWELL NJ
07006-7123
US

IV. Provider business mailing address

1129 BLOOMFIELD AVE STE 210
WEST CALDWELL NJ
07006-7123
US

V. Phone/Fax

Practice location:
  • Phone: 973-637-0101
  • Fax:
Mailing address:
  • Phone: 973-637-0101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. GALO E AGUAYO
Title or Position: DIRECTOR/OCCUPATIONAL THERAPIST
Credential: OTD, OTR/L
Phone: 973-637-0101