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General NPI Number Information
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NPI Number | 1194501361
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Entity Type | Individual
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Provider Name | STACEY ANMING PT,DPT
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Gender | Female
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Dates
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Enumeration Date | 09/05/2023
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 293 US HIGHWAY 206 UNIT 10
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City | FLANDERS
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State | NJ
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Zip | 07836-9580
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Country | US
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Telephone | 908-955-0071
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Fax |
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Provider Business Mailing Address
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Address Line | 28 HAZELTON ST
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City | RIDGEFIELD PARK
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State | NJ
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Zip | 07660-1143
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Country | US
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Telephone |
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Fax |
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 40QA02204400
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License Number State | NJ
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