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General NPI Number Information
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NPI Number | 1619486511
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Entity Type | Individual
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Provider Name | BRIAN JAMES ROBERTSON DPT
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Gender | Male
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Dates
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Enumeration Date | 09/22/2017
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 17 HAMPTON HOUSE RD STE 15D
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City | NEWTON
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State | NJ
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Zip | 07860-3404
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Country | US
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Telephone | 973-638-2243
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 CORPORATE DR STE 400
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City | HOOVER
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State | AL
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Zip | 35242-5424
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Country | US
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Telephone | 423-238-7217
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 25MT00270700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | E130955
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA02305200
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License Number State | NJ
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