Healthcare Provider Details

I. General information

NPI: 1326093907
Provider Name (Legal Business Name): DELAWARE VALLEY PHYSICAL THERAPY ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 FRANKLIN CORNER RD SUITE 103
LAWRENCEVILLE NJ
08648-2526
US

IV. Provider business mailing address

123 FRANKLIN CORNER RD SUITE 103
LAWRENCEVILLE NJ
08648-2526
US

V. Phone/Fax

Practice location:
  • Phone: 609-896-9054
  • Fax: 609-896-9059
Mailing address:
  • Phone: 609-896-9054
  • Fax: 609-896-9059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARLENE RICEVUTO
Title or Position: CHIEF FINANICAL OFFICER
Credential:
Phone: 609-896-9054