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General NPI Number Information
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NPI Number | 1043339146
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Entity Type | Individual
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Provider Name | JUDE SECHONG BLANES OTR
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Gender | Male
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 84 COLD HILL RD
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City | MENDHAM
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State | NJ
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Zip | 07945-2021
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Country | US
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Telephone | 973-543-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 44 CENTER GROVE RD APT A-17
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City | RANDOLPH
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State | NJ
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Zip | 07869-4447
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 46TR00420700
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License Number State | NJ
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