MEDICARE: DILLON DOUGLASS DPT, ATC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer	25MT00315800	NJ
2	225100000X	Physical Therapist	40QA02176600	NJ

General Provider Information

NPI Number	:	1013532357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DILLON DOUGLASS DPT, ATC

Provider Business Mailing Address
First Line	:	100 SCHINDLER CT APT 166
Second Line	:
City	:	EAST RUTHERFORD
State	:	NJ
Zip	:	07073-2173
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1925 GIANTS DR
Second Line	:
City	:	EAST RUTHERFORD
State	:	NJ
Zip	:	07073-2140
Country	:	US
Telephone Number	:	201-935-8111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2020
Last Update Date	:	04/18/2024

Similar Medicare Providers

1144282252 — MR. LEIGH JORDAN WEISS ATC, PT/DPT
Practice Location Address:

1925 GIANTS DR , TIMEX PERFORMANCE CENTER
EAST RUTHERFORD, NJ
07073-2140

Practice Phone: 201-935-8111
Practice Fax:

1538407671 — MR. JUSTIN DANIEL MAHER ATC, PT, DPT
Practice Location Address:

1925 GIANTS DR
EAST RUTHERFORD, NJ
07073-2140

Practice Phone: 201-935-8111
Practice Fax:

1023350444 — JONATHAN LIN PT, DPT, ATC, CSCS
Practice Location Address:

1925 GIANTS DR
EAST RUTHERFORD, NJ
07073-2140

Practice Phone: 206-697-2545
Practice Fax:

1013367408 — PHILIP BUZZERIO M.S. ATC
Practice Location Address:

1925 GIANTS DR
EAST RUTHERFORD, NJ
07073-2140

Practice Phone: 201-403-1513
Practice Fax:

1568139368 — MEGAN MONTGOMERY
Practice Location Address:

329 N RUTHERFORD AVE
MASSAPEQUA, NY
11758-2140

Practice Phone: 516-749-4396
Practice Fax:

1164487211 — ROCHESTER MEDICAL TRANSPORTATION
Practice Location Address:

2140 EAST MAIN ST
ROCHESTER, NY
14609

Practice Phone: 585-288-3444
Practice Fax: 585-654-9543

Directions to “ DILLON DOUGLASS DPT, ATC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.