1801010103 NPI number — MRS. DENISE MARY TEPPER M.S., P.T.

Table of content: MRS. DENISE MARY TEPPER M.S., P.T. (NPI 1801010103)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801010103 NPI number — MRS. DENISE MARY TEPPER M.S., P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TEPPER
Provider First Name:
DENISE
Provider Middle Name:
MARY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.S., P.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1801010103
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/09/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
SHORE REHABILITATION SERVICE
Provider Second Line Business Mailing Address:
ONE INDUSTRIAL WAY WEST WEST RIDGE BUILDING A.
Provider Business Mailing Address City Name:
EATONTOWN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07724
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-542-9222
Provider Business Mailing Address Fax Number:
732-542-2283

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 INDUSTRIAL WAY W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EATONTOWN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07724-2255
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-542-9222
Provider Business Practice Location Address Fax Number:
732-542-2283
Provider Enumeration Date:
04/11/2007

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 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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