Provider Demographics
NPI:1790880581
Name:SABIN, JACQUELINE MARY (MS OTR/L)
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:MARY
Last Name:SABIN
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MANFRE CT
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-9338
Mailing Address - Country:US
Mailing Address - Phone:917-612-5097
Mailing Address - Fax:
Practice Address - Street 1:727 N BEERS ST
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1514
Practice Address - Country:US
Practice Address - Phone:732-739-5955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011003-1225XH1200X
NJ46TR00392300225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand