Provider Demographics
NPI:1194299735
Name:FALZARANO, JACQUELINE N (OTR/L)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:N
Last Name:FALZARANO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 BEACON HILL RD
Mailing Address - Street 2:
Mailing Address - City:CALIFON
Mailing Address - State:NJ
Mailing Address - Zip Code:07830-3520
Mailing Address - Country:US
Mailing Address - Phone:908-524-8728
Mailing Address - Fax:
Practice Address - Street 1:9 MOUNT PLEASANT TPKE
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-3624
Practice Address - Country:US
Practice Address - Phone:973-216-1008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-16
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00850000225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist