MEDICARE: VALERIE ELIE PT

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	225100000X	Physical Therapist	P82256	NY
2	225100000X	Physical Therapist	40QA02002100	NJ

General Provider Information

NPI Number	:	1023378379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE ELIE PT

Provider Business Mailing Address
First Line	:	230 MERRITT AVE
Second Line	:
City	:	BERGENFIELD
State	:	NJ
Zip	:	07621-1417
Country	:	US
Telephone Number	:	845-517-9159
Fax Number	:

Provider Business Practice Location Address
First Line	:	725 RIVER RD STE 107B
Second Line	:
City	:	EDGEWATER
State	:	NJ
Zip	:	07020-1149
Country	:	US
Telephone Number	:	201-770-7845
Fax Number	:

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

Provider Enumeration Date	:	05/21/2012
Last Update Date	:	10/25/2023

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Directions to “ VALERIE ELIE PT” Practice Location

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