Individual
SHANTAL TAGALOG TUBALADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9 HARBOR FRONT CT, ELIZABETH, NJ 07206-1951
(848) 236-6636
Mailing address
9 HARBOR FRONT CT, ELIZABETH, NJ 07206-1951
(848) 236-6636
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
050083
NY
Other
Enumeration date
12/13/2023
Last updated
12/13/2023
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