Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 40QA01100200 | NJ |
NPI | 1003097502 |
---|---|
Provider Name | Carlos Neilfreid Monterroyo |
First Address | Cherry Hill, NJ 08002-3801 |
Second Address | Moorestown, NJ 08057-1625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2007 |
Last Update Date | 27/11/2007 |