Provider Demographics
NPI:1366907776
Name:KATZ, ROCHELLE (OT)
Entity type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:
Last Name:KATZ
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 1:85 CANARY DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5453
Mailing Address - Country:US
Mailing Address - Phone:917-589-6734
Mailing Address - Fax:
Practice Address - Street 1:85 CANARY DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5453
Practice Address - Country:US
Practice Address - Phone:917-589-6734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-10
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023347225X00000X
NJ46T00880200225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist