Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 40QA01540300 | NJ |
NPI | 1083031801 |
---|---|
Provider Name | Danielle Cherry |
First Address | Howell, NJ 07731-2628 |
Second Address | Toms River, NJ 08755-1490 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2014 |
Last Update Date | 19/03/2014 |