Provider Demographics
NPI:1376388298
Name:JORDAN, CARA MARIE (OTR/L)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:MARIE
Last Name:JORDAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 STUYVESANT AVE UNIT 1B
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071-1878
Mailing Address - Country:US
Mailing Address - Phone:551-497-8899
Mailing Address - Fax:
Practice Address - Street 1:79 HUDSON ST STE 404
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-5641
Practice Address - Country:US
Practice Address - Phone:201-222-9576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01084100225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist