Provider Demographics
NPI:1801019187
Name:NIMBVIKAR, SANJYOT A (OT)
Entity Type:Individual
Prefix:MS
First Name:SANJYOT
Middle Name:A
Last Name:NIMBVIKAR
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 WHITEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-3329
Mailing Address - Country:US
Mailing Address - Phone:973-326-1108
Mailing Address - Fax:
Practice Address - Street 1:33 BLEEKER ST
Practice Address - Street 2:
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1459
Practice Address - Country:US
Practice Address - Phone:973-379-8400
Practice Address - Fax:973-379-8484
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00053800225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist