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NPI Code Detail

MEDICARE: MR. PAUL HEIM P.T.

MEDICARE: MR. PAUL HEIM 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
1225100000XPhysical Therapist40QA00404100NJ

General Provider Information

NPI Number : 1982654208
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PAUL HEIM P.T.
Provider Business Mailing Address
First Line : 1377 MOTOR PKWY
Second Line : STE 307
City : ISLANDIA
State : NY
Zip : 11749-5258
Country : US
Telephone Number : 856-690-9977
Fax Number : 856-507-9918
Provider Business Practice Location Address
First Line : 1940 S WEST BLVD
Second Line : BLDG A
City : VINELAND
State : NJ
Zip : 08360-7024
Country : US
Telephone Number : 856-690-9977
Fax Number : 856-507-9918
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2006
Last Update Date : 03/07/2017

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