Provider Demographics
NPI:1689438475
Name:BEHL, PRIYA (MSCOT)
Entity Type:Individual
Prefix:MS
First Name:PRIYA
Middle Name:
Last Name:BEHL
Suffix:
Gender:F
Credentials:MSCOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 LOLLER DRIVE
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08836-2027
Mailing Address - Country:US
Mailing Address - Phone:201-912-2184
Mailing Address - Fax:
Practice Address - Street 1:99 GLEN COVE AVE
Practice Address - Street 2:
Practice Address - City:SEWAREN
Practice Address - State:NJ
Practice Address - Zip Code:07077-1134
Practice Address - Country:US
Practice Address - Phone:732-602-8428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00605500225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0450705978OtherNEW JERSEY DEPARTMENT OF TREASURY - DIVISION OF REVENUE AND ENTERPRISE SERVICES