Provider Demographics
NPI:1992252423
Name:MUCHNICK, JOSHUA (OTR/L)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:
Last Name:MUCHNICK
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 1:826 GREEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-2944
Mailing Address - Country:US
Mailing Address - Phone:732-987-6008
Mailing Address - Fax:
Practice Address - Street 1:826 GREEN VALLEY ROAD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-2944
Practice Address - Country:US
Practice Address - Phone:732-987-6008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00739100225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist