Provider Demographics
NPI:1184458911
Name:BATTLE, JOHN ROBERT JR (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ROBERT
Last Name:BATTLE
Suffix:JR
Gender:M
Credentials:OTD, OTR/L
Other - Prefix:DR
Other - First Name:JACK
Other - Middle Name:ROBERT
Other - Last Name:BATTLE
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:OTD, OTR/L
Mailing Address - Street 1:164 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:DUMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:07628-2740
Mailing Address - Country:US
Mailing Address - Phone:201-787-6592
Mailing Address - Fax:
Practice Address - Street 1:1400 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-3537
Practice Address - Country:US
Practice Address - Phone:201-357-0417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01158100225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist