Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 40QA01564900 | NJ |
NPI | 1003215419 |
---|---|
Provider Name | Jaclyn Paler |
First Address | Lyndhurst, NJ 07071-3621 |
Second Address | Dumont, NJ 07628-3066 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2014 |
Last Update Date | 21/08/2014 |