Faith Jennifer Gross

Individual provider Active NPI Physical Therapy Assistant · Oakland, NJ

NPI 1124668686 · NPPES record last updated Jan 13, 2020

Key facts

NPI
1124668686
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
40QA01897900 (NJ)
Practice address
340 Ramapo Valley Rd
Oakland, NJ 07436-2711
Phone
(201) 651-9100
NPI assigned
Jan 13, 2020
Sex
Female
Sole proprietor
No

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
40QA01897900NJMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 40QA01897900 NJ Yes

Addresses

Primary practice location

340 Ramapo Valley Rd
Oakland, NJ 07436-2711

Mailing address

12 Board Rd
Hewitt, NJ 07421-3168
Phone (973) 934-6485

Other providers in Oakland, NJ

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

Sources for this page

Verify at the official NPI Registry.