Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 40QA01979600 | NJ |
NPI | 1043814536 |
---|---|
Provider Name | Dr. Anthony Celenza |
First Address | Mount Ephraim, NJ 08059-1523 |
Second Address | Mount Ephraim, NJ 08059-1523 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2020 |
Last Update Date | 24/11/2020 |