Organization
PRO STAFF DYNAMIC HAND THERAPY, INC.
Active
Other names
Pro Staff Rehab & Wellness, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JACLYN ANN KOPIDLOWSKI MS, OTR/L, CHT (OWNER)
(973) 766-3523
Entity
Organization
Contact information
Practice address
49 CLAREMONT AVE, SUITE 5, MONTCLAIR, NJ 07042-4854
(973) 680-8390
(973) 680-8391
Mailing address
265 FRANKLIN AVE, NUTLEY, NJ 07110-2712
(973) 680-8390
(973) 680-8391
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
46TR00508400
NJ
261QP2000X
Physical Therapy Clinic/Center
—
—
261QR0404X
Cardiac Rehabilitation Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
01/22/2014
Last updated
05/29/2015
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