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General NPI Number Information
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NPI Number | 1043448467
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Entity Type | Individual
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Provider Name | RENEE BAGLEY
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Gender | Female
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Dates
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Enumeration Date | 06/24/2009
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Last Update Date | 06/24/2009
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Provider Practice Location Address
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Address Line | 531 ROUTE 57 E
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City | WASHINGTON
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State | NJ
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Zip | 07882-2440
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Country | US
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Telephone | 908-835-1600
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Fax | 908-835-1601
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Provider Business Mailing Address
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Address Line | 157 CENTER ST
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City | CLINTON
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State | NJ
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Zip | 08809-1337
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Country | US
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Telephone | 908-684-5800
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Fax | 908-684-5606
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01177300
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License Number State | NJ
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