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General NPI Number Information
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NPI Number | 1164912317
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Entity Type | Organization
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Legal Business Name | AQUATIC INSTITUTE OF NEW JERSEY LLC
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Dates
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Enumeration Date | 05/14/2018
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Last Update Date | 05/14/2024
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Provider Practice Location Address
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Address Line | 415 ARLINGTON AVE
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4868
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Country | US
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Telephone | 908-415-3857
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Fax | 732-942-9529
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Provider Business Mailing Address
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Address Line | 415 ARLINGTON AVE
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4868
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Country | US
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Telephone | 908-415-3857
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Fax | 732-942-9529
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Authorized Official
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Title or Position | OWNER
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Name | HADASSA MOSKOVITS
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Credential | OTR
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Telephone | 732-942-9529
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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