Provider Demographics
NPI:1972277218
Name:TUKAY, JOSEL
Entity Type:Individual
Prefix:
First Name:JOSEL
Middle Name:
Last Name:TUKAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 BROOKDALE GDNS APT B
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-6385
Mailing Address - Country:US
Mailing Address - Phone:862-285-6280
Mailing Address - Fax:
Practice Address - Street 1:277 PROSPECT AVE STE LG
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2539
Practice Address - Country:US
Practice Address - Phone:201-968-0303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TA09208700224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant