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Individual

NICHOLAS PARKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
COTA/L

Contact information

Practice address
540 W HANOVER AVE, MORRIS PLAINS, NJ 07950-2152
(973) 607-2319
Mailing address
55 MARCIA RD, RINGWOOD, NJ 07456-1833
(973) 934-8329

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
011297
NY
224Z00000X
Occupational Therapy Assistant
Primary
46TA09237400
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
011297
NEW YORK STATE EDUCATION DEPARTMENT
NY
01
46TA09237400
NJ DIVISION OF CONSUMER AFFAIRS
NJ
Enumeration date
02/27/2023
Last updated
02/27/2023
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