Healthcare Provider Details

I. General information

NPI: 1407860877
Provider Name (Legal Business Name): PHILIP R ALBERT PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

784 CHIMNEY ROCK RD SUITE E
MARTINSVILLE NJ
08836-2237
US

IV. Provider business mailing address

2 OWENS DR
WARREN NJ
07059-6716
US

V. Phone/Fax

Practice location:
  • Phone: 732-302-1860
  • Fax: 732-302-0881
Mailing address:
  • Phone: 908-507-8580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA00000600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: