Provider Demographics
NPI:1457166548
Name:BRIGHT BEGINNINGS PEDIATRIC THERAPY SJ
Entity type:Organization
Organization Name:BRIGHT BEGINNINGS PEDIATRIC THERAPY SJ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SERENA
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:COTA/L
Authorized Official - Phone:609-407-3809
Mailing Address - Street 1:516 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08215-4029
Mailing Address - Country:US
Mailing Address - Phone:609-276-8553
Mailing Address - Fax:
Practice Address - Street 1:769 ROUTE 70 E STE C175
Practice Address - Street 2:
Practice Address - City:EVESHAM
Practice Address - State:NJ
Practice Address - Zip Code:08053-2360
Practice Address - Country:US
Practice Address - Phone:609-407-3809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty