Healthcare Provider Details

I. General information

NPI: 1942877725
Provider Name (Legal Business Name): DANA NORFLETT PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2021
Last Update Date: 06/10/2021
Certification Date: 06/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 OCEANPORT AVE STE 2
LITTLE SILVER NJ
07739-1250
US

IV. Provider business mailing address

70 BROADWAY APT 4
KEYPORT NJ
07735-1074
US

V. Phone/Fax

Practice location:
  • Phone: 732-758-0002
  • Fax: 732-219-0979
Mailing address:
  • Phone: 732-618-5343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA02011200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: