Individual
INGRID PAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
388 POMPTON AVE, CEDAR GROVE, NJ 07009-1814
(973) 228-0500
(973) 228-0501
Mailing address
388 POMPTON AVE, CEDAR GROVE, NJ 07009-1814
(973) 228-0500
(973) 228-0501
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00396200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40QA00396200
PHYSICAL THERAPY STATE LICENSE
NJ
Enumeration date
05/19/2016
Last updated
05/19/2016
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