Healthcare Provider Details

I. General information

NPI: 1407710338
Provider Name (Legal Business Name): GISELE ANDRADE ESPIN PT
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

140 PARK AVE
FLORHAM PARK NJ
07932-1049
US

IV. Provider business mailing address

137 CENTRAL AVE
WEST CALDWELL NJ
07006-7748
US

V. Phone/Fax

Practice location:
  • Phone: 973-285-7613
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA01567500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: