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General NPI Number Information
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NPI Number | 1669633285
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Entity Type | Organization
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Legal Business Name | A STEP AHEAD THERAPY SERVICES LIMITED LIABILITY COMPANY
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Dates
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Enumeration Date | 06/17/2008
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Last Update Date | 06/02/2009
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Provider Practice Location Address
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Address Line | 1166 RIVER AVE
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5600
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Country | US
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Telephone | 732-370-0070
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Fax |
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Provider Business Mailing Address
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Address Line | 514 AZALEA DR
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City | BRICK
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State | NJ
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Zip | 08724-2732
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Country | US
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Telephone | 732-899-0779
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Fax | 732-903-6081
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MS. MARY E BUCKLEY
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Credential | PT
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Telephone | 732-267-0852
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 40QA00097700
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License Number State | NJ
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