Provider Demographics
NPI:1477045359
Name:INFINITY OT
Entity Type:Organization
Organization Name:INFINITY OT
Other - Org Name:INFINITY PEDIATRIC OT & SWIM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR/L
Authorized Official - Phone:603-848-1677
Mailing Address - Street 1:36 COPPER HILL PARK
Mailing Address - Street 2:
Mailing Address - City:RINGWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07456-2820
Mailing Address - Country:US
Mailing Address - Phone:603-848-1677
Mailing Address - Fax:
Practice Address - Street 1:72 NEW LONDON DR
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NH
Practice Address - Zip Code:03303
Practice Address - Country:US
Practice Address - Phone:603-848-1677
Practice Address - Fax:603-746-2958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-05
Last Update Date:2021-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1890225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3078299Medicaid