Provider Demographics
NPI:1528404522
Name:BUNKERS, JENNIFER MELISSA (OTR/L)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MELISSA
Last Name:BUNKERS
Suffix:
Gender:F
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 1:29 STONEHILL RD
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:07419-2549
Mailing Address - Country:US
Mailing Address - Phone:973-803-0260
Mailing Address - Fax:
Practice Address - Street 1:197 CAHILL CROSS RD
Practice Address - Street 2:
Practice Address - City:WEST MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07480-1947
Practice Address - Country:US
Practice Address - Phone:973-506-7730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00174400225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist