Provider Demographics
NPI:1407478142
Name:BAKRI, POOJA (LCAT, ATR-BC)
Entity Type:Individual
Prefix:MS
First Name:POOJA
Middle Name:
Last Name:BAKRI
Suffix:
Gender:F
Credentials:LCAT, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 EDGECLIFF RD
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-1112
Mailing Address - Country:US
Mailing Address - Phone:917-544-3748
Mailing Address - Fax:
Practice Address - Street 1:33 PLYMOUTH ST STE 301
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2677
Practice Address - Country:US
Practice Address - Phone:718-715-0230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-16
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ12-230221700000X
NY001577221700000X
NJ16LP00007500221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Single Specialty