Provider Demographics
NPI:1487291670
Name:GARCIA, JOSE ANTONIO ANAEL JAUGAN (OTR)
Entity type:Individual
Prefix:
First Name:JOSE ANTONIO ANAEL
Middle Name:JAUGAN
Last Name:GARCIA
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 YALE ST APT D
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-5315
Mailing Address - Country:US
Mailing Address - Phone:862-220-2313
Mailing Address - Fax:
Practice Address - Street 1:2 YALE ST APT D
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-5315
Practice Address - Country:US
Practice Address - Phone:862-220-2313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-06
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist