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General NPI Number Information
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NPI Number | 1114101086
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Entity Type | Individual
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Provider Name | SIMONE CASTOR PT
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Gender | Female
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 01/28/2008
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Provider Practice Location Address
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Address Line | 80 MAIN ST 2ND FLOOR
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City | WEST ORANGE
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State | NJ
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Zip | 07052-5460
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Country | US
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Telephone | 973-324-2111
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Fax | 397-324-5880
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Provider Business Mailing Address
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Address Line | 66 W GILBERT ST 2ND FLOOR
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City | TINTON FALLS
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State | NJ
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Zip | 07701-4947
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Country | US
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Telephone | 732-212-0051
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Fax | 732-212-0052
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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 | 40QA00731000
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License Number State | NJ
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