MEDICARE: MRS. JANE DELANEY 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
1	225100000X	Physical Therapist	40QA00497000	NJ

General Provider Information

NPI Number	:	1780657163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANE DELANEY P.T.

Provider Business Mailing Address
First Line	:	1033 BOWSPRIT PT
Second Line	:
City	:	LANOKA HARBOR
State	:	NJ
Zip	:	08734-2706
Country	:	US
Telephone Number	:	609-971-3734
Fax Number	:

Provider Business Practice Location Address
First Line	:	137 ATLANTIC CITY BLVD
Second Line	:	SUITE 2
City	:	BEACHWOOD
State	:	NJ
Zip	:	08722-2935
Country	:	US
Telephone Number	:	732-244-8666
Fax Number	:	732-244-0450

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

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	09/15/2010

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