Provider Demographics
NPI:1013077585
Name:PROGRESSIVE HAND THERAPY, LLC
Entity type:Organization
Organization Name:PROGRESSIVE HAND THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED HAND THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAYNE
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:HURST
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTRL, CHT
Authorized Official - Phone:201-497-6211
Mailing Address - Street 1:99 KINDERKAMACK RD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-3012
Mailing Address - Country:US
Mailing Address - Phone:201-497-6211
Mailing Address - Fax:201-497-6212
Practice Address - Street 1:99 KINDERKAMACK RD
Practice Address - Street 2:SUITE 112
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-3012
Practice Address - Country:US
Practice Address - Phone:201-497-6211
Practice Address - Fax:201-497-6212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ116582Medicare PIN
NJ6053840001Medicare NSC