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NPI Code Detail

MEDICARE: KEVIN SHALOO

MEDICARE:   KEVIN  SHALOO
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 Therapist40QA01906800NJ

General Provider Information

NPI Number : 1336786516
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN SHALOO
Provider Business Mailing Address
First Line : 3525 QUAKERBRIDGE RD STE 6000
Second Line :
City : HAMILTON
State : NJ
Zip : 08619-1266
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3525 QUAKERBRIDGE RD STE 6000
Second Line :
City : HAMILTON
State : NJ
Zip : 08619-1266
Country : US
Telephone Number : 609-890-9195
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2019
Last Update Date : 12/05/2019

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Directions to “ KEVIN SHALOO ” Practice Location

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