MEDICARE: TREVOR FENNELL

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
1	225100000X	Physical Therapist	40QA00907400	NJ

General Provider Information

NPI Number	:	1619904125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TREVOR FENNELL

Provider Business Mailing Address
First Line	:	127 UNION ST
Second Line	:	SUITE 105
City	:	RIDGEWOOD
State	:	NJ
Zip	:	07450
Country	:	US
Telephone Number	:	201-444-4447
Fax Number	:	201-444-5101

Provider Business Practice Location Address
First Line	:	127 UNION ST
Second Line	:	SUITE 105
City	:	RIDGEWOOD
State	:	NJ
Zip	:	07450-4478
Country	:	US
Telephone Number	:	201-444-4447
Fax Number	:	201-444-5101

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1689653909 — DR. JEFFREY BRIAN DANZIG M.D.
Practice Location Address:

127 UNION ST
RIDGEWOOD, NJ
07450-4478

Practice Phone: 201-445-8787
Practice Fax: 201-445-8556

1427013937 — DR. CAROLYN MUDRY D.O.
Practice Location Address:

127 UNION ST
RIDGEWOOD, NJ
07450-4478

Practice Phone: 201-444-5200
Practice Fax: 201-444-2399

1750475075 — ALLEN SILVERSTEIN MD
Practice Location Address:

127 UNION ST
RIDGEWOOD, NJ
07450-4478

Practice Phone: 201-447-0472
Practice Fax:

1659459949 — GAYATHRI SASTRY MD
Practice Location Address:

257 E RIDGEWOOD AVENUE , SUITE 200
RIDGEWOOD, NJ
07450-4478

Practice Phone: 201-445-2200
Practice Fax: 201-445-2204

1275748717 — DR. ALIMA BIBI FAROOKI M.D.
Practice Location Address:

127 UNION ST , SUITE 106
RIDGEWOOD, NJ
07450-4478

Practice Phone: 201-444-6140
Practice Fax: 201-444-6148

1578759239 — RONALD A WHITE MD
Practice Location Address:

127 UNION ST
RIDGEWOOD, NJ
07450-4478

Practice Phone: 201-447-4466
Practice Fax:

Directions to “ TREVOR FENNELL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.