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General NPI Number Information
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NPI Number | 1235594979
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Entity Type | Organization
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Legal Business Name | NEMATULLAH VASOWALA
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Dates
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Enumeration Date | 12/23/2015
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Last Update Date | 12/19/2016
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Provider Practice Location Address
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Address Line | 1 S WOODLEIGH DR
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City | CHERRY HILL
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State | NJ
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Zip | 08003-3145
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Country | US
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Telephone | 856-427-7917
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Fax |
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Provider Business Mailing Address
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Address Line | 1 S WOODLEIGH DR
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City | CHERRY HILL
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State | NJ
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Zip | 08003-3145
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Country | US
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Telephone | 856-427-7917
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | NEMATULLAH Q VASOWALA
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Credential | PT
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Telephone | 401-369-6952
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 40QA01668100
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License Number State | NJ
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