Provider Demographics
NPI:1801021654
Name:MOHINDROO, PRIYANKA (BS OT)
Entity Type:Individual
Prefix:
First Name:PRIYANKA
Middle Name:
Last Name:MOHINDROO
Suffix:
Gender:F
Credentials:BS OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PEACHTREE LN
Mailing Address - Street 2:
Mailing Address - City:JAMESBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-2532
Mailing Address - Country:US
Mailing Address - Phone:908-510-8969
Mailing Address - Fax:
Practice Address - Street 1:1 PEACHTREE LANE
Practice Address - Street 2:
Practice Address - City:JAMESBURG
Practice Address - State:NJ
Practice Address - Zip Code:08831
Practice Address - Country:US
Practice Address - Phone:908-510-8969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-22
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00264700225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist