Provider Demographics
NPI:1689248742
Name:MENDONCA, ROCHELLE JILLIAN (PHD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:ROCHELLE
Middle Name:JILLIAN
Last Name:MENDONCA
Suffix:
Gender:F
Credentials:PHD, OTR/L
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Other - Last Name:
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Mailing Address - Street 1:2100 LINWOOD AVE APT 16T
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-3160
Mailing Address - Country:US
Mailing Address - Phone:414-412-1280
Mailing Address - Fax:
Practice Address - Street 1:617 W 168TH ST RM 312
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3925
Practice Address - Country:US
Practice Address - Phone:414-412-1280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-13
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY025635225XE0001X, 225XE1200X, 225XG0600X, 225XH1300X, 225XN1300X, 224ZE0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224ZE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantEnvironmental Modification
No225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental Modification
No225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomics
No225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology
No225XH1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHuman Factors
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJM25166607155801OtherDMV