Provider Demographics
NPI:1659676476
Name:JAMES, ELLEN (EDD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:EDD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:197 ASHLAND AVE # 1
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-2418
Mailing Address - Country:US
Mailing Address - Phone:973-415-9405
Mailing Address - Fax:
Practice Address - Street 1:197 ASHLAND AVE # 1
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-2418
Practice Address - Country:US
Practice Address - Phone:973-415-9405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-26
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016465-1225X00000X, 225XP0200X
NJ46TR00552000225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics