Healthcare Provider Details

I. General information

NPI: 1740114636
Provider Name (Legal Business Name): BRETT MILDEN PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 ALMONESSON RD STE 7
DEPTFORD NJ
08096-5260
US

IV. Provider business mailing address

18 FOSTERTOWN LN
MULLICA HILL NJ
08062-2204
US

V. Phone/Fax

Practice location:
  • Phone: 856-352-0621
  • Fax:
Mailing address:
  • Phone: 609-314-4443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA02423100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: