Provider Demographics
NPI:1578849378
Name:BRIGHT STAR THERAPY L.L.C.
Entity Type:Organization
Organization Name:BRIGHT STAR THERAPY L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:HAIKEN
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:732-667-7778
Mailing Address - Street 1:266 KING GEORGE RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-5120
Mailing Address - Country:US
Mailing Address - Phone:732-667-7778
Mailing Address - Fax:732-667-7780
Practice Address - Street 1:266 KING GEORGE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5120
Practice Address - Country:US
Practice Address - Phone:732-667-7778
Practice Address - Fax:732-667-7780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-25
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC003573001041C0700X
NJ40QA00819800225100000X
2251P0200X, 225XP0200X, 235Z00000X
NJ46TR00249600225X00000X, 225XP0200X
NJ41YS00259000235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty