Healthcare Provider Details

I. General information

NPI: 1922035435
Provider Name (Legal Business Name): WILLIAM JAMES NASH P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 BRIDGEBORO RD
DELRAN NJ
08075-9700
US

IV. Provider business mailing address

263 ARNEYS MT RD
PEMBERTON NJ
08068
US

V. Phone/Fax

Practice location:
  • Phone: 856-764-0494
  • Fax: 856-764-0580
Mailing address:
  • Phone: 609-261-4205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number40QA00184700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: