Healthcare Provider Details

I. General information

NPI: 1053749994
Provider Name (Legal Business Name): CARA YEZZI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2013
Last Update Date: 10/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 PLEASANT HILL RD
CHESTER NJ
07930-2141
US

IV. Provider business mailing address

201 PLEASANT HILL RD
CHESTER NJ
07930-2141
US

V. Phone/Fax

Practice location:
  • Phone: 973-252-6400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA01450100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: