Healthcare Provider Details

I. General information

NPI: 1366917841
Provider Name (Legal Business Name): CAMRYN ALKES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2018
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 BRIGHTON RD
CLIFTON NJ
07012-1400
US

IV. Provider business mailing address

38 HILLCREST AVE
HAWTHORNE NJ
07506-3114
US

V. Phone/Fax

Practice location:
  • Phone: 973-874-0888
  • Fax:
Mailing address:
  • Phone: 201-575-9511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA02289300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: