Doctor Name: | EDILBERTO O ESTOMO |
NPI Number: | 1720138191 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 40QA00520400 |
Business Practice Address: | 54 E Main St Bergenfield, NJ - 07621 |
Business Phone Number: | 2018749084 |
Business Fax Number: | 9739097656 |
Mailing Address: | Po Box 29, EDGEWATER |
State: | NJ |
Postal Code: | 07020 |
Phone Number: | 9733616054 |
Fax Number: | 9733610272 |
NPI Enumeration Date: | 01/10/2007 |
NPI Last Update Date: | 02/22/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 40QA00520400 |
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 |