Provider Demographics
NPI:1326925694
Name:TAUBER, SUSSY (OTR/L)
Entity type:Individual
Prefix:
First Name:SUSSY
Middle Name:
Last Name:TAUBER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:SUSSY
Other - Middle Name:
Other - Last Name:MAYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:88 WADSWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-6136
Mailing Address - Country:US
Mailing Address - Phone:347-831-2826
Mailing Address - Fax:
Practice Address - Street 1:88 WADSWORTH AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-6136
Practice Address - Country:US
Practice Address - Phone:347-831-2826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-19
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01253300225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist