Individual
ANTHONY JOSEPH IADISERNIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1 MAIN ST STE 505, EATONTOWN, NJ 07724-3903
(732) 493-3100
Mailing address
1 MAIN ST STE 505, EATONTOWN, NJ 07724-3903
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01941700
NJ
Other
Enumeration date
08/20/2020
Last updated
08/20/2020
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