Provider Demographics
NPI:1760720122
Name:JURADO, DINNO PAULO VILLARAMA (OTR/L)
Entity Type:Individual
Prefix:
First Name:DINNO PAULO
Middle Name:VILLARAMA
Last Name:JURADO
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 POMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07009-1813
Mailing Address - Country:US
Mailing Address - Phone:973-433-0732
Mailing Address - Fax:
Practice Address - Street 1:88 MAIN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:LITTLE FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07424-1412
Practice Address - Country:US
Practice Address - Phone:877-887-3574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-19
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00602100225X00000X
NY014277225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist