Healthcare Provider Details

I. General information

NPI: 1326198615
Provider Name (Legal Business Name): THOMAS BARTOLINO PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 10/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 DENOW RD STE U
PENNINGTON NJ
08534-5246
US

IV. Provider business mailing address

800 DENOW RD STE U
PENNINGTON NJ
08534-5246
US

V. Phone/Fax

Practice location:
  • Phone: 609-737-8130
  • Fax: 609-737-8131
Mailing address:
  • Phone: 609-737-8130
  • Fax: 609-737-8131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA00170000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: