Individual
ANDREW EADES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9 MARY LN, WALDWICK, NJ 07463-1010
(201) 739-9320
Mailing address
9 MARY LN, WALDWICK, NJ 07463-1010
(201) 739-9320
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00643100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
271878734
DYNAMIC PHYSICAL THERAPY
NJ
Enumeration date
05/01/2019
Last updated
05/01/2019
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