Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 40QA01312900 | NJ |
NPI | 1265781660 |
---|---|
Provider Name | Christine M Durbin |
First Address | Pompton Lakes, NJ 07442-1770 |
Second Address | Morristown, NJ 07960-7330 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2012 |
Last Update Date | 31/08/2012 |