Healthcare Provider Details

I. General information

NPI: 1285598136
Provider Name (Legal Business Name): EMILY VANDERSLEEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 WALTER E FORAN BLVD STE 4004
FLEMINGTON NJ
08822-4675
US

IV. Provider business mailing address

4 WALTER E FORAN BLVD STE 203
FLEMINGTON NJ
08822-4666
US

V. Phone/Fax

Practice location:
  • Phone: 908-824-2923
  • Fax:
Mailing address:
  • Phone: 908-237-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA02391400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: