Healthcare Provider Details

I. General information

NPI: 1972071793
Provider Name (Legal Business Name): DAVID F HOTALING DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2018
Last Update Date: 03/26/2020
Certification Date: 03/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1931 WASHINGTON VALLEY RD
MARTINSVILLE NJ
08836-2029
US

IV. Provider business mailing address

8 BOND PL
NORTH ARLINGTON NJ
07031-5853
US

V. Phone/Fax

Practice location:
  • Phone: 732-552-0275
  • Fax: 732-855-9755
Mailing address:
  • Phone: 973-986-1467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA01828800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: