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General NPI Number Information
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NPI Number | 1134940042
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Entity Type | Individual
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Provider Name | STEPHANIE M THOMPSON OT
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Gender | Female
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Dates
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Enumeration Date | 10/23/2024
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 220 LIVINGSTON ST STE 108
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City | NORTHVALE
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State | NJ
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Zip | 07647-1739
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Country | US
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Telephone | 201-564-7515
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Fax | 201-564-7514
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Provider Business Mailing Address
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Address Line | 401 SEMINO RD
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City | NORTHVALE
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State | NJ
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Zip | 07647-1210
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Country | US
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Telephone | 201-835-2323
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Fax | 201-564-7514
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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 | 46TR01210000
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License Number State | NJ
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