Provider Demographics
NPI:1245601947
Name:MCCARTY, JESSIE (OT)
Entity Type:Individual
Prefix:
First Name:JESSIE
Middle Name:
Last Name:MCCARTY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 WINGED FOOT DR
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-9332
Mailing Address - Country:US
Mailing Address - Phone:732-216-7602
Mailing Address - Fax:
Practice Address - Street 1:21 WINGED FOOT DR
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-9332
Practice Address - Country:US
Practice Address - Phone:732-216-7602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-07
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00708000225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist