Healthcare Provider Details

I. General information

NPI: 1053221937
Provider Name (Legal Business Name): CHARLENE ASHLEY MORALES PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

626 RIDGE RD
LYNDHURST NJ
07071-3206
US

IV. Provider business mailing address

202 AMES AVE
BERGENFIELD NJ
07621-1125
US

V. Phone/Fax

Practice location:
  • Phone: 201-372-3240
  • Fax:
Mailing address:
  • Phone: 201-375-5672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA02448500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: