Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 40QA01360100 | NJ |
NPI | 1003124934 |
---|---|
Provider Name | Matthew Toth |
First Address | West Trenton, NJ 08628-3018 |
Second Address | West Trenton, NJ 08628-3018 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2010 |
Last Update Date | 14/09/2010 |