Doctor Name: | NICOLE RUSSO |
NPI Number: | 1013337864 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT, DPT |
License Number: | 40QA01532600 |
Business Practice Address: | 2123 Highway 35 Sea Girt, NJ - 087501003 |
Business Phone Number: | 7324492001 |
Business Fax Number: | |
Mailing Address: | 2123 Highway 35, SEA GIRT |
State: | NJ |
Postal Code: | 087501003 |
Phone Number: | 7324492001 |
Fax Number: | |
NPI Enumeration Date: | 04/21/2014 |
NPI Last Update Date: | 04/21/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 40QA01532600 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |