Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 226300000X | Kinesiotherapist | 1357611112 | NJ |
NPI | 1770962326 |
---|---|
Provider Name | Matthew Schinelli |
First Address | Little Falls, NJ 07424 |
Second Address | Little Falls, NJ 07424 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2015 |
Last Update Date | 05/01/2017 |