Healthcare Provider Details

I. General information

NPI: 1134278393
Provider Name (Legal Business Name): DIANE R. SALANDRA PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIANE R. KUCHEN PT

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date: 04/06/2024
Reactivation Date: 05/28/2026

III. Provider practice location address

95 SOMERVILLE RD
BEDMINSTER NJ
07921-2638
US

IV. Provider business mailing address

981 US HIGHWAY 22
BRIDGEWATER NJ
08807-2946
US

V. Phone/Fax

Practice location:
  • Phone: 908-234-9668
  • Fax: 908-234-1343
Mailing address:
  • Phone: 201-535-8522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA00390000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: