Provider Demographics
NPI:1740556067
Name:PROFESSIONAL THERAPY ASSOCIATES
Entity type:Organization
Organization Name:PROFESSIONAL THERAPY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:G
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:732-701-3711
Mailing Address - Street 1:2557 HOOPER AVE
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-6238
Mailing Address - Country:US
Mailing Address - Phone:732-701-3711
Mailing Address - Fax:732-701-3709
Practice Address - Street 1:2557 HOOPER AVE
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-6238
Practice Address - Country:US
Practice Address - Phone:732-701-3711
Practice Address - Fax:732-701-3709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-30
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00074400225XP0200X
NJ46TR00233800225XP0200X
NJ41S00260100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty