Healthcare Provider Details

I. General information

NPI: 1194933937
Provider Name (Legal Business Name): HEIDI CIPRIANO P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 LASATTA AVE
ENGLISHTOWN NJ
07726-1656
US

IV. Provider business mailing address

14 MANOR DR
MANALAPAN NJ
07726-3120
US

V. Phone/Fax

Practice location:
  • Phone: 732-786-1000
  • Fax:
Mailing address:
  • Phone: 732-492-4273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA00955300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: