Provider Demographics
NPI:1851594790
Name:THE CHILDREN'S THERAPY CENTER OF NORTH JERSEY
Entity Type:Organization
Organization Name:THE CHILDREN'S THERAPY CENTER OF NORTH JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA OTR L
Authorized Official - Phone:973-209-4064
Mailing Address - Street 1:100 QUARRY RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HAMBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:07419-1339
Mailing Address - Country:US
Mailing Address - Phone:973-209-4064
Mailing Address - Fax:973-209-4867
Practice Address - Street 1:100 QUARRY RD
Practice Address - Street 2:SUITE 2
Practice Address - City:HAMBURG
Practice Address - State:NJ
Practice Address - Zip Code:07419-1339
Practice Address - Country:US
Practice Address - Phone:973-209-4064
Practice Address - Fax:973-209-4867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
NJ40QA00237200225100000X
NJ46TR000845000225XP0200X
NJ41YS00300300235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1851594790OtherCIGNA
NJ1851594790OtherOXFORDHMO/LIBERTYNETWORK
NJ1851594790OtherB/C-B/S
NJ1851594790OtherAETNA
NJ1851594790OtherEMPIRE B/C B/S