Individual
GERALD MADDALONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1715 ROUTE 88 W, BRICK, NJ 08724-3008
(732) 458-7976
Mailing address
2248 BLANSING RD, MANASQUAN, NJ 08736-1308
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
QA094650
LICENSE#
NJ
Enumeration date
08/17/2007
Last updated
08/17/2007
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