Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 40QA01022200 | NJ |
NPI | 1114130440 |
---|---|
Provider Name | Mr. Brian Christopher Perkowski |
First Address | Westampton, NJ 08060-2361 |
Second Address | Hamilton, NJ 08619-1205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 08/07/2007 |