Individual
MR. JOHN CARL PERALTA PINEDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
77 DOTY RD, HASKELL, NJ 07420-3713
(917) 618-9881
Mailing address
77 DOTY RD, HASKELL, NJ 07420
(917) 618-9881
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
029628
NY
225100000X
Physical Therapist
Primary
40QA01347600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40QA01347600
PT LICENSE
NJ
Enumeration date
11/19/2010
Last updated
03/17/2018
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