| Doctor Name: | DR. ALEXANDER FORMOLOW |
| NPI Number: | 1326115635 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.P.T. |
| License Number: | 40QA01092200 |
| Business Practice Address: | 220 Sunset Rd Suite 5a And B Willingboro, NJ - 080461126 |
| Business Phone Number: | 6098354801 |
| Business Fax Number: | |
| Mailing Address: | 703 Begonia Ct, JACKSON |
| State: | NJ |
| Postal Code: | 085274176 |
| Phone Number: | 7329391360 |
| Fax Number: | |
| NPI Enumeration Date: | 11/29/2006 |
| NPI Last Update Date: | 03/06/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 40QA01092200 |
| 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 |