Organization
MY THERAPY CLUBHOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAIGA HAGER OTR/L (OWNER)
(732) 644-6643
Entity
Organization
Contact information
Practice address
140 BROOK AVE, PASSAIC, NJ 07055-4440
(732) 644-6643
Mailing address
140 BROOK AVE, PASSAIC, NJ 07055-4440
(732) 644-6643
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124785209
INSURANCE
—
05
—
1124785209
—
NJ
Enumeration date
03/01/2023
Last updated
03/01/2023
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