Organization
PEDIATRIC THERAPY CENTER OF NJ LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARISSA L JANNICELLI PAMPANIN OTR (DIRECTOR)
(973) 865-9321
Entity
Organization
Contact information
Practice address
912 POMPTON AVE STE B1, CEDAR GROVE, NJ 07009-1264
(973) 680-1971
Mailing address
912 POMPTON AVE STE B1, CEDAR GROVE, NJ 07009-1264
(973) 680-1971
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
04/13/2021
Last updated
04/22/2021
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