Provider Demographics
NPI:1225405970
Name:YAACOBY, RUTH (MS, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:
Last Name:YAACOBY
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 COUNTY ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TENATLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670
Mailing Address - Country:US
Mailing Address - Phone:201-894-5800
Mailing Address - Fax:201-894-5990
Practice Address - Street 1:120 COUNTY ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:TENATLY
Practice Address - State:NJ
Practice Address - Zip Code:07670
Practice Address - Country:US
Practice Address - Phone:201-894-5800
Practice Address - Fax:201-894-5990
Is Sole Proprietor?:No
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00251300225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics