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NPI Code Detail

MEDICARE: MRS. BRENDA MARIA CAMPANELLA PT

MEDICARE: MRS. BRENDA MARIA CAMPANELLA PT
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 Therapist40QA00521500NJ

General Provider Information

NPI Number : 1730490020
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRENDA MARIA CAMPANELLA PT
Provider Business Mailing Address
First Line : 1 MAIN ST STE 505
Second Line :
City : EATONTOWN
State : NJ
Zip : 07724-3903
Country : US
Telephone Number : 732-493-3100
Fax Number : 732-876-4967
Provider Business Practice Location Address
First Line : 1 MAIN ST STE 505
Second Line :
City : EATONTOWN
State : NJ
Zip : 07724-3903
Country : US
Telephone Number : 732-493-3100
Fax Number : 732-876-4967
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2010
Last Update Date : 12/16/2019

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