Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 40QA01041900 | NJ |
NPI | 1003064882 |
---|---|
Provider Name | Steven Andrew Tasetano |
First Address | Washington, NJ 07882 |
Second Address | Washington, NJ 07882 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2008 |
Last Update Date | 04/09/2008 |