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Individual

ANDREW ATALLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
622 EAGLE ROCK AVE, SUIT 104, WEST ORANGE, NJ 07052-2994
(973) 669-0078
Mailing address
622 EAGLE ROCK AVE, SUIT 104, WEST ORANGE, NJ 07052-2994
(973) 669-0078

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01805500
NJ
225200000X
Physical Therapy Assistant
40QB00311300
NJ

Other

Enumeration date
08/13/2014
Last updated
02/13/2020
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