Provider Demographics
NPI:1629489604
Name:SENSORY SMART OT
Entity Type:Organization
Organization Name:SENSORY SMART OT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPY
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:DICHTER
Authorized Official - Suffix:
Authorized Official - Credentials:MS OTR/L
Authorized Official - Phone:732-252-6666
Mailing Address - Street 1:900 W MAIN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2523
Mailing Address - Country:US
Mailing Address - Phone:732-252-6666
Mailing Address - Fax:732-431-3603
Practice Address - Street 1:900 W MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2523
Practice Address - Country:US
Practice Address - Phone:732-252-6666
Practice Address - Fax:732-431-3603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00062200174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1912207747OtherNPI