MEDICARE: NANCY F BELIVEAU PT, DPT

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	40QA01387100	NJ

General Provider Information

NPI Number	:	1730486994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY F BELIVEAU PT, DPT

Provider Business Mailing Address
First Line	:	PO BOX 240
Second Line	:
City	:	COLTS NECK
State	:	NJ
Zip	:	07722-0240
Country	:	US
Telephone Number	:	732-252-6155
Fax Number	:	732-362-4718

Provider Business Practice Location Address
First Line	:	420 STATE ROUTE 34 STE 317
Second Line	:
City	:	COLTS NECK
State	:	NJ
Zip	:	07722-2517
Country	:	US
Telephone Number	:	732-252-6155
Fax Number	:	732-362-4718

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

Provider Enumeration Date	:	02/23/2011
Last Update Date	:	02/26/2019

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