Provider Demographics
NPI:1609494475
Name:DANLASKY, JHEYSON GUIDO (OTA)
Entity Type:Individual
Prefix:
First Name:JHEYSON
Middle Name:GUIDO
Last Name:DANLASKY
Suffix:
Gender:M
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 PARK PL APT 5J
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-3759
Mailing Address - Country:US
Mailing Address - Phone:551-404-2364
Mailing Address - Fax:
Practice Address - Street 1:421 PARK PL APT 5J
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-3759
Practice Address - Country:US
Practice Address - Phone:551-404-2364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-08
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010362-01224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant