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Organization
PANDA PHYSICAL MEDICINE LLC
Active
Organization
PANDA PHYSICAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES A FERRANTE DC (CLINIC MANAGER)
(732) 455-1375
Entity
Organization
Contact information
Practice address
142 HIGHWAY 35 STE 107, EATONTOWN, NJ 07724-1864
(732) 898-3040
(732) 531-1200
Mailing address
904 DEAL RD APT 12, OCEAN, NJ 07712-3443
(732) 455-1375
(732) 230-7680
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
NULL
111N00000X
Chiropractor
—
—
174400000X
Specialist
—
NULL
174400000X
Specialist
—
—
363L00000X
Nurse Practitioner
Primary
—
NULL
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/23/2018
Last updated
05/27/2022
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