Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | 40QB00028400 | NJ |
N | 2251X0800X | Physical Therapist - Orthopedic | 40QB00028400 | NJ |
N | 225200000X | Physical Therapy Assistant | 40QB00028400 | NJ |
NPI | 1295790467 |
---|---|
Provider Name | Mrs. Elizabeth J Connelly-Platanella |
First Address | Linwood, NJ 08221-1251 |
Second Address | Linwood, NJ 08221-1251 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 08/07/2007 |