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General NPI Number Information
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NPI Number | 1598292484
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Entity Type | Individual
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Provider Name | EILEEN DALTON PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 05/22/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 121 CENTER GROVE RD
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City | RANDOLPH
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State | NJ
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Zip | 07869-4453
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Country | US
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Telephone | 973-361-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 121 CENTER GROVE RD
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City | RANDOLPH
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State | NJ
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Zip | 07869-4453
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Country | US
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Telephone | 973-361-5500
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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 | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 40QA01727100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 40QA01727100
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License Number State | NJ
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