Provider Demographics
NPI:1043953086
Name:TAYLOR, SEAN PATRICK (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:PATRICK
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 BRYCE CT
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-5033
Mailing Address - Country:US
Mailing Address - Phone:201-360-7918
Mailing Address - Fax:
Practice Address - Street 1:100 CRAIG RD STE 102
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8731
Practice Address - Country:US
Practice Address - Phone:201-360-7918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01055900225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics