MEDICARE: TIFFANY JOY OCANA OT

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
1	225X00000X	Occupational Therapist	TROO297100	NJ

General Provider Information

NPI Number	:	1154449387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY JOY OCANA OT

Provider Business Mailing Address
First Line	:	528 WILLIAM ST
Second Line	:
City	:	SCOTCH PLAINS
State	:	NJ
Zip	:	07076-1910
Country	:	US
Telephone Number	:	908-228-2290
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 ROUTE 3
Second Line	:	GROUND FLR
City	:	CLIFTON
State	:	NJ
Zip	:	07013-3928
Country	:	US
Telephone Number	:	908-771-5789
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	10/18/2012

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