Provider Demographics
NPI:1144307489
Name:SLOOP, JUDITH A (DSC, OTR)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:A
Last Name:SLOOP
Suffix:
Gender:F
Credentials:DSC, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CORPORATE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-8736
Mailing Address - Country:US
Mailing Address - Phone:732-761-0302
Mailing Address - Fax:732-761-0305
Practice Address - Street 1:300 CORPORATE CENTER DR
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8736
Practice Address - Country:US
Practice Address - Phone:732-761-0302
Practice Address - Fax:732-761-0305
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
FLOT9336225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL885410600Medicaid
FL811532000Medicaid