Individual
DR. AMANDA THERESA BURSESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
65 BERGEN ST, NEWARK, NJ 07107-3001
(973) 461-6337
Mailing address
123 KNOLL TER, WEST CALDWELL, NJ 07006-7300
(973) 461-6337
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
040788-1
NY
225100000X
Physical Therapist
Primary
40QA01621700
NJ
Other
Enumeration date
06/23/2017
Last updated
06/23/2017
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