Individual
JAY KOENIGSBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
804 RYDERS LN, EAST BRUNSWICK, NJ 08816-5849
(732) 238-4010
Mailing address
18 COLBUM RD, EAST BRUNSWICK, NJ 08816
(732) 545-9990
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40QA00597700
LICENSE#
NJ
Enumeration date
08/29/2006
Last updated
07/08/2007
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