Organization
E.M. DELLAGATTA PT PA
Active
Other names
Maple Leaf Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ENRICO MICHAEL DELLAGATTA M.ED, DPT (CEO)
(609) 561-1974
Entity
Organization
Contact information
Practice address
255 MESSINA AVE, HAMMONTON, NJ 08037-1327
(609) 561-1974
(609) 567-3148
Mailing address
255 MESSINA AVE, PO BOX 663, HAMMONTON, NJ 08037-1327
(609) 561-1974
(609) 567-3148
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00109200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
055839
AETNA
NJ
01
—
3K4079
HEALTHNET
NJ
01
—
67001
CIGNA
NJ
01
—
P1709594
OXFORD
NJ
Enumeration date
05/08/2007
Last updated
04/20/2008
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