Individual
PATRICIA A BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11C BROOKSIDE HTS, WANAQUE, NJ 07465-1622
(201) 887-0636
Mailing address
11C BROOKSIDE HTS, WANAQUE, NJ 07465-1622
(201) 887-0636
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
40QA00349700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40QA00349700
PHYSICAL THERAPY LICENSE NUMBER
NJ
Enumeration date
06/03/2020
Last updated
06/03/2020
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