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General NPI Number Information
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NPI Number | 1457166548
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Entity Type | Organization
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Legal Business Name | BRIGHT BEGINNINGS PEDIATRIC THERAPY SJ
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Dates
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Enumeration Date | 02/07/2025
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 769 ROUTE 70 E STE C175
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City | EVESHAM
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State | NJ
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Zip | 08053-2360
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Country | US
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Telephone | 609-407-3809
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Fax |
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Provider Business Mailing Address
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Address Line | 516 4TH AVE
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City | EGG HARBOR CITY
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State | NJ
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Zip | 08215-4029
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Country | US
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Telephone | 609-276-8553
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SERENA LYN LOPEZ
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Credential | COTA/L
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Telephone | 609-407-3809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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