Provider Demographics
NPI:1942842182
Name:NIED, CHRISTINA KAYLEE (MS, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:KAYLEE
Last Name:NIED
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 KAREN PL
Mailing Address - Street 2:
Mailing Address - City:BUDD LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07828-1014
Mailing Address - Country:US
Mailing Address - Phone:201-919-4560
Mailing Address - Fax:
Practice Address - Street 1:156 RT. 15 NORTH
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:NJ
Practice Address - Zip Code:07848
Practice Address - Country:US
Practice Address - Phone:973-862-6377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00892400225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics