MEDICARE: DR. JACQUELINE DANIEL OTD

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	46TR01198900	NJ

General Provider Information

NPI Number	:	1417808585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACQUELINE DANIEL OTD

Provider Business Mailing Address
First Line	:	945 RIVER AVE STE 201
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-5675
Country	:	US
Telephone Number	:	732-833-3723
Fax Number	:

Provider Business Practice Location Address
First Line	:	51 CRAGWOOD RD STE 100
Second Line	:
City	:	SOUTH PLAINFIELD
State	:	NJ
Zip	:	07080-2405
Country	:	US
Telephone Number	:	732-833-3723
Fax Number	:

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

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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