Provider Demographics
NPI:1528296332
Name:KAPEL, ILLYCE (OT)
Entity type:Individual
Prefix:
First Name:ILLYCE
Middle Name:
Last Name:KAPEL
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 HOLMDEL RD
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1661
Mailing Address - Country:US
Mailing Address - Phone:732-539-6535
Mailing Address - Fax:928-222-5626
Practice Address - Street 1:785 HOLMDEL RD
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1661
Practice Address - Country:US
Practice Address - Phone:732-539-6535
Practice Address - Fax:928-222-5626
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00120400225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics