Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 46TR00830200 | NJ |
NPI | 1003458852 |
---|---|
Provider Name | Jan Josef Sanchez |
First Address | Eatontown, NJ 07724-3903 |
Second Address | Eatontown, NJ 07724-3903 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2019 |
Last Update Date | 14/10/2019 |