MEDICARE: MONIKA GUTIERREZ DPT

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
2	2251X0800X	Orthopedic Physical Therapist	40QA01894500	NJ

General Provider Information

NPI Number	:	1790343069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONIKA GUTIERREZ DPT

Provider Business Mailing Address
First Line	:	12 HUMBERT ST
Second Line	:
City	:	NUTLEY
State	:	NJ
Zip	:	07110-1911
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 ROUTE 23 STE 205
Second Line	:
City	:	POMPTON PLAINS
State	:	NJ
Zip	:	07444-1025
Country	:	US
Telephone Number	:	973-706-1130
Fax Number	:

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

Provider Enumeration Date	:	06/03/2019
Last Update Date	:	05/28/2025

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Directions to “ MONIKA GUTIERREZ DPT” Practice Location

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