Healthcare Provider Details

I. General information

NPI: 1568468072
Provider Name (Legal Business Name): BAY-SEA PHYSICAL THERAPY OF BRIDGETON PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 07/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 LAUREL HEIGHTS DR BLDG 4
BRIDGETON NJ
08302-3634
US

IV. Provider business mailing address

232 LAUREL HEIGHTS DR BLDG 4
BRIDGETON NJ
08302-3634
US

V. Phone/Fax

Practice location:
  • Phone: 856-455-9730
  • Fax: 855-455-5165
Mailing address:
  • Phone: 856-455-9730
  • Fax: 855-455-5165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DONNA BUSCEMI
Title or Position: BILLING MANAGER
Credential:
Phone: 856-455-9730