Provider Demographics
NPI:1881717015
Name:HURST, JUSTIN WILLIAM (MS, OTR/L; CHT)
Entity type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:WILLIAM
Last Name:HURST
Suffix:
Gender:M
Credentials:MS, OTR/L; CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00291600225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ092497W54Medicare UPIN