Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 40QA01399900 | NJ |
NPI | 1053695239 |
---|---|
Provider Name | Mrs. Danielle T Ayer |
First Address | Berkeley Heights, NJ 07922-1105 |
Second Address | Mountainside, NJ 07092-2590 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2011 |
Last Update Date | 05/10/2011 |