Provider Demographics
NPI:1053002998
Name:THAKKER, CHINMAYI (OT)
Entity type:Individual
Prefix:
First Name:CHINMAYI
Middle Name:
Last Name:THAKKER
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 1:897 US HIGHWAY 130
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-2907
Mailing Address - Country:US
Mailing Address - Phone:609-912-4477
Mailing Address - Fax:609-642-4227
Practice Address - Street 1:897 US HIGHWAY 130
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-2907
Practice Address - Country:US
Practice Address - Phone:609-912-4477
Practice Address - Fax:609-642-4227
Is Sole Proprietor?:No
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00308100225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist