Provider Demographics
NPI:1932653862
Name:JOOYANDEHNIK, ORAH
Entity Type:Individual
Prefix:
First Name:ORAH
Middle Name:
Last Name:JOOYANDEHNIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-3121
Mailing Address - Country:US
Mailing Address - Phone:908-205-9184
Mailing Address - Fax:
Practice Address - Street 1:834 UNION AVE
Practice Address - Street 2:
Practice Address - City:HILLSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07205-3121
Practice Address - Country:US
Practice Address - Phone:908-205-9184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-09
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020726225X00000X
NJ46TR00742200225X00000X
MD08821225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist