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NPI Code Detail

MEDICARE: DAVID PHILIP DEMAREO MSPT

MEDICARE: DAVID PHILIP DEMAREO MSPT
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
1225100000XPhysical Therapist40QA01174100NJ

General Provider Information

NPI Number : 1699769547
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID PHILIP DEMAREO MSPT
Provider Business Mailing Address
First Line : 2027 GALE AVE
Second Line :
City : MAYS LANDING
State : NJ
Zip : 08330-3930
Country : US
Telephone Number : 609-625-2901
Fax Number :
Provider Business Practice Location Address
First Line : 4622 BLACK HORSE PIKE
Second Line :
City : MAYS LANDING
State : NJ
Zip : 08330-3213
Country : US
Telephone Number : 609-909-5005
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2005
Last Update Date : 07/08/2007

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Directions to “ DAVID PHILIP DEMAREO MSPT” Practice Location

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