Provider Demographics
NPI:1528239472
Name:BAYANIN, JOHN ALADA (OTR/L)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ALADA
Last Name:BAYANIN
Suffix:
Gender:M
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 1:17 WALNUT ST
Mailing Address - Street 2:APT. D3
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-5299
Mailing Address - Country:US
Mailing Address - Phone:732-357-5631
Mailing Address - Fax:
Practice Address - Street 1:17 WALNUT ST
Practice Address - Street 2:APT. D3
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-5299
Practice Address - Country:US
Practice Address - Phone:732-357-5631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00450700225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist