Provider Demographics
NPI:1912247057
Name:KROTT, JENNIFER (OT)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:KROTT
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 1:1377 MOTOR PKWY
Mailing Address - Street 2:STE 307
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-5258
Mailing Address - Country:US
Mailing Address - Phone:631-580-5200
Mailing Address - Fax:856-234-4241
Practice Address - Street 1:5000 SAGEMORE DR
Practice Address - Street 2:SUITE 103
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-4307
Practice Address - Country:US
Practice Address - Phone:856-983-4263
Practice Address - Fax:856-983-9362
Is Sole Proprietor?:No
Enumeration Date:2013-02-27
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00070900225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist