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General NPI Number Information
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NPI Number | 1457786287
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Entity Type | Individual
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Provider Name | DANIEL JAMES MCCARRON PTA
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Gender | Male
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Dates
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Enumeration Date | 09/11/2013
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Last Update Date | 09/11/2013
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Provider Practice Location Address
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Address Line | 380 DEMOTT LN
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City | SOMERSET
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State | NJ
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Zip | 08873-2762
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Country | US
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Telephone | 732-873-2000
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Fax | 732-873-6550
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Provider Business Mailing Address
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Address Line | 19 UPPER BROOK DR
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902-1210
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Country | US
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Telephone | 732-297-4430
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 40QB00187900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 6121
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License Number State | MA
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