Organization
PEDZ THERAPLAY SPOT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BAKULA PATEL PT/DPT (MANAGING DIRECTOR)
(973) 652-0201
Entity
Organization
Contact information
Practice address
21 FOOTE LN, MORRIS PLAINS, NJ 07950-3307
(973) 652-0201
(973) 530-4002
Mailing address
21 FOOTE LN, MORRIS PLAINS, NJ 07950-3307
(973) 652-0201
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
03/06/2020
Last updated
12/05/2024
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