Healthcare Provider Details

I. General information

NPI: 1780657163
Provider Name (Legal Business Name): JANE DELANEY P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 09/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 ATLANTIC CITY BLVD SUITE 2
BEACHWOOD NJ
08722-2935
US

IV. Provider business mailing address

1033 BOWSPRIT PT
LANOKA HARBOR NJ
08734-2706
US

V. Phone/Fax

Practice location:
  • Phone: 732-244-8666
  • Fax: 732-244-0450
Mailing address:
  • Phone: 609-971-3734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA00497000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: