Organization Name: | AVENEL PHYSICAL THERAPY |
NPI Number: | 1194914416 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL F DILELLA (PHSYICAL THERAPIST/PRESIDENT) |
Mailing Address: | 415 Avenel St Avenel |
State: | NJ US |
Postal Code: | 070011147 |
Phone Number: | 7326367888 |
Fax Number: | 7326367887 |
NPI Enumeration Date: | 10/23/2007 |
NPI Last Update Date: | 10/23/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 40QA01192300 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |