Provider Demographics
NPI:1891155594
Name:BORNSTEIN, JAMIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:BORNSTEIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:886 VILLAGE GRN
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-3516
Mailing Address - Country:US
Mailing Address - Phone:908-370-9592
Mailing Address - Fax:
Practice Address - Street 1:886 VILLAGE GRN
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-3516
Practice Address - Country:US
Practice Address - Phone:908-370-9592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY63020362225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist