Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 40QA00874200 | NJ |
NPI | 1043480486 |
---|---|
Provider Name | Ms. Marylouise Jani |
First Address | Lawrenceville, NJ 08648-4839 |
Second Address | Pennington, NJ 08534-5246 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/02/2008 |
Last Update Date | 29/02/2008 |