Healthcare Provider Details

I. General information

NPI: 1003856055
Provider Name (Legal Business Name): VIRGINIA J. MILLAR D.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 12/12/2022
Certification Date: 12/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 N MAIN ST
CAPE MAY COURT HOUSE NJ
08210-2192
US

IV. Provider business mailing address

10 NADINE BLVD
OCEAN VIEW NJ
08230-1709
US

V. Phone/Fax

Practice location:
  • Phone: 609-536-4995
  • Fax: 609-478-2082
Mailing address:
  • Phone: 609-846-4968
  • Fax: 609-478-2082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number40QA00517200
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA00517200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: