Organization
JERSEY PHYSICAL THERAPY OF MILLTOWN/EAST BRUNSWICK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEAN T. MOORE PT, MPT (MANAGING MEMBER)
(732) 418-7033
Entity
Organization
Contact information
Practice address
180 TICES LN, EAST BRUNSWICK, NJ 08816-1337
(732) 418-7033
(732) 418-7011
Mailing address
3228 STATE ROUTE 27, KENDALL PARK, NJ 08824-1524
(732) 297-0032
(732) 418-7011
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7074461
AETNA PROVIDER NUMBER
NJ
Enumeration date
05/09/2006
Last updated
03/03/2014
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