Provider Demographics
NPI:1972193365
Name:JJW OCCUPATIONAL THERAPY PC
Entity Type:Organization
Organization Name:JJW OCCUPATIONAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:E
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS OTR/L
Authorized Official - Phone:347-956-6445
Mailing Address - Street 1:198-01 C 67TH AVE
Mailing Address - Street 2:APT. 1A
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-4281
Mailing Address - Country:US
Mailing Address - Phone:347-956-6445
Mailing Address - Fax:
Practice Address - Street 1:198-01 C 67TH AVE
Practice Address - Street 2:APT. 1A
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-4281
Practice Address - Country:US
Practice Address - Phone:347-956-6445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-20
Last Update Date:2023-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health