Provider Demographics
NPI:1194236596
Name:BORAD, NIRALI P (OTRL)
Entity type:Individual
Prefix:
First Name:NIRALI
Middle Name:P
Last Name:BORAD
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-1506
Mailing Address - Country:US
Mailing Address - Phone:973-928-6334
Mailing Address - Fax:973-928-6335
Practice Address - Street 1:124 GREGORY AVE
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-4856
Practice Address - Country:US
Practice Address - Phone:973-657-6334
Practice Address - Fax:973-657-6335
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-12
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00704300225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty