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NPI Code Detail

MEDICARE: CHARLES E ARCHBALD III P.T.

MEDICARE: CHARLES E ARCHBALD III P.T.
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 Therapist40QA01019800NJ
2174400000XSpecialist40QA01049800NJ

General Provider Information

NPI Number : 1346296860
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES E ARCHBALD III P.T.
Provider Business Mailing Address
First Line : 1 HIGH ST
Second Line :
City : ALLENTOWN
State : NJ
Zip : 08501-1914
Country : US
Telephone Number : 609-259-5394
Fax Number :
Provider Business Practice Location Address
First Line : 1900 ARENA DR
Second Line :
City : HAMILTON
State : NJ
Zip : 08610-2409
Country : US
Telephone Number : 609-585-2333
Fax Number : 609-585-6522
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2006
Last Update Date : 09/12/2008

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