Provider Demographics
NPI:1962561845
Name:DOSHI, TRACY HAZEN (OT,CHT)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:HAZEN
Last Name:DOSHI
Suffix:
Gender:F
Credentials:OT,CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 CHIPPING WOODS CT
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-2154
Mailing Address - Country:US
Mailing Address - Phone:609-654-4439
Mailing Address - Fax:
Practice Address - Street 1:128 ROUTE 70
Practice Address - Street 2:SUITE 2C
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-2371
Practice Address - Country:US
Practice Address - Phone:609-953-7227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR004284225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand