Rosa Abreu-Gallardo

Individual provider Active NPI Physical Therapy Assistant · Bloomfield, NJ

NPI 1104256247 · NPPES record last updated Nov 26, 2013

Key facts

NPI
1104256247
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
40QB00256500 (NJ)
Practice address
250 Bloomfield Ave
Bloomfield, NJ 07003
Phone
(888) 873-4221
NPI assigned
Nov 26, 2013
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
40QB00256500NJMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Infectious Diseases North PC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 40QB00256500 NJ Yes

Addresses

Primary practice location

250 Bloomfield Ave
Bloomfield, NJ 07003

Mailing address

417 N 7TH St
Newark, NJ 07107-1732

Other providers in Bloomfield, NJ

All providers in Bloomfield, NJ · Physical Therapy Assistant in New Jersey

Sources for this page

Verify at the official NPI Registry.