Individual
ANNYENI M DORMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 NOYES DR, PARK RIDGE, NJ 07656-1294
(201) 505-1777
Mailing address
336 PROSPECT AVE, HACKENSACK, NJ 07601-2506
(201) 678-1800
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
40QA01219700
NJ
225100000X
Physical Therapist
Primary
PT020467
PA
Other
Enumeration date
04/14/2010
Last updated
04/14/2010
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