| Doctor Name: | M. P. NISPEROS |
| NPI Number: | 1285760710 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | PT40QA01110500 |
| Business Practice Address: | 517 Central Ave Ste 1 Orange, NJ - 070501433 |
| Business Phone Number: | 9734141357 |
| Business Fax Number: | |
| Mailing Address: | 53 Linden Ave, SPRINGFIELD |
| State: | NJ |
| Postal Code: | 070811805 |
| Phone Number: | 9737047734 |
| Fax Number: | 8556314348 |
| NPI Enumeration Date: | 02/26/2007 |
| NPI Last Update Date: | 05/31/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT40QA01110500 |
| 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 |