Individual
JACK EDWARD CROKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
250 RIVER ST, HACKENSACK, NJ 07601-7514
(201) 992-0178
Mailing address
148 PRISCILLA DR, LINCROFT, NJ 07738-1242
(732) 757-6056
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR01110900
NJ
Other
Enumeration date
03/03/2023
Last updated
07/27/2023
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