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Organization
PREMIUM THERAPEUTICS
Active
Organization
PREMIUM THERAPEUTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STANFORD JOSEPH PTA (OWNER)
(347) 526-1502
Entity
Organization
Contact information
Practice address
179 BRECKENRIDGE DR, SICKLERVILLE, NJ 08081-3240
(347) 526-1502
Mailing address
179 BRECKENRIDGE DR, SICKLERVILLE, NJ 08081-3240
(347) 526-1502
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
—
—
Other
Enumeration date
02/10/2026
Last updated
03/10/2026
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