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NPI Code Detail

MEDICARE: BRIELLE JUSSSEN OTR

MEDICARE: BRIELLE JUSSSEN OTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist46TR01005700NJ

General Provider Information

NPI Number : 1073392452
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIELLE JUSSSEN OTR
Provider Business Mailing Address
First Line : 61 PIROGUE ST
Second Line :
City : TOMS RIVER
State : NJ
Zip : 08757-4136
Country : US
Telephone Number : 973-652-9822
Fax Number :
Provider Business Practice Location Address
First Line : 2 HOLLYWOOD BLVD N STE 8
Second Line :
City : FORKED RIVER
State : NJ
Zip : 08731-4842
Country : US
Telephone Number : 609-200-1118
Fax Number : 866-368-4449
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2023
Last Update Date : 09/26/2023

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Directions to “ BRIELLE JUSSSEN OTR” Practice Location

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