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Organization

HAWTHORNE PEDIATRIC THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. STANTON WILLIAM SHERIDAN II MS, OTR (OWNER)
(201) 500-8014
Entity
Organization

Contact information

Practice address
173 PASADENA PL, HAWTHORNE, NJ 07506-2838
(201) 500-8014
Mailing address
173 PASADENA PL, HAWTHORNE, NJ 07506-2838
(201) 500-8014

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary

Other

Enumeration date
01/30/2022
Last updated
01/30/2022
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