MEDICARE: MR. PAUL GUY AMALFITANO DPT, ATC

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	40QA01181800	NJ

General Provider Information

NPI Number	:	1689660086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PAUL GUY AMALFITANO DPT, ATC

Provider Business Mailing Address
First Line	:	4250 HARBOR BEACH BLVD
Second Line	:
City	:	BRIGANTINE
State	:	NJ
Zip	:	08203-1361
Country	:	US
Telephone Number	:	609-264-8800
Fax Number	:	609-264-0097

Provider Business Practice Location Address
First Line	:	4250 HARBOR BEACH BLVD
Second Line	:
City	:	BRIGANTINE
State	:	NJ
Zip	:	08203-1361
Country	:	US
Telephone Number	:	609-264-8800
Fax Number	:	609-264-0097

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

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	08/01/2020

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