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NPI Code Detail

MEDICARE: MICHELLE RAY PT

MEDICARE: MICHELLE RAY PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist40QA01692000NJ
2225100000XPhysical Therapist026525-1NY

General Provider Information

NPI Number : 1255871935
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE RAY PT
Provider Business Mailing Address
First Line : 85 ROUTE 17 SOUTH
Second Line :
City : ALLENDALE
State : NJ
Zip : 07401
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 85 HARRETON RD
Second Line :
City : ALLENDALE
State : NJ
Zip : 07401-1317
Country : US
Telephone Number : 201-825-0660
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2017
Last Update Date : 03/01/2017

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Directions to “ MICHELLE RAY PT” Practice Location

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