Provider Demographics
NPI:1871004184
Name:SCHAD, NANCY MARIE (COTA)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:MARIE
Last Name:SCHAD
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:MISS
Other - First Name:NANCY
Other - Middle Name:MARIE
Other - Last Name:BINISZKIEWICZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:360 E PLEASANT GROVE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-4240
Mailing Address - Country:US
Mailing Address - Phone:732-833-9171
Mailing Address - Fax:
Practice Address - Street 1:75 OLD TOMS RIVER RD
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-7800
Practice Address - Country:US
Practice Address - Phone:732-451-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-14
Last Update Date:2017-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TA09048000224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant