Individual
NINA M MINEO-PANKIEWITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
144 ROUTE 34, MATAWAN, NJ 07747-2132
(732) 320-6285
(732) 374-9864
Mailing address
144 ROUTE 34, MATAWAN, NJ 07747-2132
(732) 320-6285
(732) 374-9864
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00399700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40QB00399700
LICENSE
NJ
Enumeration date
09/01/2022
Last updated
09/01/2022
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