Provider Demographics
NPI:1033188891
Name:STAINO, MICHAEL JOHN (OTR, CHT, COMT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JOHN
Last Name:STAINO
Suffix:
Gender:M
Credentials:OTR, CHT, COMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 NAUTILUS DR STE 1
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-2466
Mailing Address - Country:US
Mailing Address - Phone:609-978-1001
Mailing Address - Fax:609-978-0914
Practice Address - Street 1:44 NAUTILUS DR STE 1
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2466
Practice Address - Country:US
Practice Address - Phone:609-978-1001
Practice Address - Fax:609-978-0914
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00173100225X00000X, 225XH1200X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ989330OtherNBCOT
NJ9911000080OtherHTCC
NJTR01731OtherLICENCE