1588863369 NPI number — MRS. MARTHA L STURVENT PHYSICAL THERAPY

Table of content: MRS. MARTHA L STURVENT PHYSICAL THERAPY (NPI 1588863369)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588863369 NPI number — MRS. MARTHA L STURVENT PHYSICAL THERAPY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STURVENT
Provider First Name:
MARTHA
Provider Middle Name:
L
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PHYSICAL THERAPY
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TRUXEL
Provider Other First Name:
MARTHA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHYSICAL THERAPY
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1588863369
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/12/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16 VALLEYVIEW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WARREN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07059-5228
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-829-8484
Provider Business Mailing Address Fax Number:
973-829-8485

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PGCSCHOOL
Provider Second Line Business Practice Location Address:
15 HALKO DRIVE
Provider Business Practice Location Address City Name:
CEDAR KNOLLS
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07927
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-829-8484
Provider Business Practice Location Address Fax Number:
973-829-8485
Provider Enumeration Date:
07/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  40QA00104400 , 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)





Copyright © 2007-2025 www.npivalidator.com