| Doctor Name: | MR. JASON THOMAS FOGU |
| NPI Number: | 1538243670 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHYSICAL THERAPIST |
| License Number: | 40QA00679700 |
| Business Practice Address: | 21 -29 West 25th Street Bayonne, NJ - 070027300 |
| Business Phone Number: | 2013394160 |
| Business Fax Number: | 2013394592 |
| Mailing Address: | 11 Humphrey Ave, BAYONNE |
| State: | NJ |
| Postal Code: | 070027300 |
| Phone Number: | 2012404587 |
| Fax Number: | |
| NPI Enumeration Date: | 10/25/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 40QA00679700 |
| 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 |