Healthcare Provider Details

I. General information

NPI: 1972981249
Provider Name (Legal Business Name): SABRINA TATE HEGARTY PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2015
Last Update Date: 05/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 ADAMS COURT
WESTWOOD NJ
07675
US

IV. Provider business mailing address

38 ADAMS COURT
WESTWOOD NJ
07675
US

V. Phone/Fax

Practice location:
  • Phone: 201-953-0634
  • Fax:
Mailing address:
  • Phone: 201-953-0634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number40QA01093500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: