Individual
MR. JASON THOMAS FOGU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Contact information
Practice address
21 -29 WEST 25TH STREET, BAYONNE, NJ 07002-7300
(201) 339-4160
(201) 339-4592
Mailing address
11 HUMPHREY AVE, BAYONNE, NJ 07002-7300
(201) 240-4587
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00679700
NJ
Other
Enumeration date
10/25/2006
Last updated
07/08/2007
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