Organization
COLONIAL PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RALPH DESIDERIO M.S.P.T. (CO-OWNER)
(732) 615-9622
Entity
Organization
Contact information
Practice address
1702 STATE ROUTE 35, MIDDLETOWN, NJ 07748-1832
(732) 615-9622
(732) 615-9624
Mailing address
1702 STATE ROUTE 35, MIDDLETOWN, NJ 07748-1832
(732) 615-9622
(732) 615-9624
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
40QA00806100
NJ
2251X0800X
Orthopedic Physical Therapist
40QA00884200
NJ
Other
Enumeration date
12/26/2006
Last updated
08/22/2020
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