1497894794 NPI number — WALLOP INC

Table of content: (NPI 1497894794)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497894794 NPI number — WALLOP INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WALLOP INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PREMIER PHYSICAL THERAPY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497894794
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 PRINCETON HIGHTSTOWN RD
Provider Second Line Business Mailing Address:
BLDG A SUITE 201
Provider Business Mailing Address City Name:
EAST WINDSOR
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08520
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-426-4442
Provider Business Mailing Address Fax Number:
609-443-0910

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
666 PLAINSBORO RD
Provider Second Line Business Practice Location Address:
SUITE 1210 PREMIER PHYSICAL THERAPY
Provider Business Practice Location Address City Name:
PLAINSBORO
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08536
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-936-1666
Provider Business Practice Location Address Fax Number:
609-936-9449
Provider Enumeration Date:
02/05/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PALLOP
Authorized Official First Name:
MARCIA
Authorized Official Middle Name:
NEIBERG
Authorized Official Title or Position:
VP
Authorized Official Telephone Number:
609-936-1666

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)