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General NPI Number Information
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NPI Number | 1205446101
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Entity Type | Individual
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Provider Name | JABARI KAMAU HOYTE OTD, OTR/L
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Gender | Male
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Dates
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Enumeration Date | 08/05/2020
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Last Update Date | 08/05/2020
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Provider Practice Location Address
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Address Line | 111 DEAN DR # 1N
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City | TENAFLY
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State | NJ
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Zip | 07670-2764
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Country | US
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Telephone | 201-503-7173
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Fax |
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Provider Business Mailing Address
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Address Line | 181 RIVER ROAD BUILDING 2 APT. 4A
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City | NUTLEY
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State | NJ
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Zip | 07110
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Country | US
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Telephone | 917-697-8012
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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 | 46TR00937500
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License Number State | NJ
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