Gregory Matthew Minnis, DPT
Individual provider Active NPI Physical Therapist · Wall, NJ
NPI 1245569490 · NPPES record last updated Jan 14, 2021
Key facts
- NPI
- 1245569490
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 40QA01312300 (NJ)
- Practice address
- 2510 Belmar Blvd # J1-2
Wall, NJ 07719-3948 - Phone
- (732) 681-1122
- NPI assigned
- Dec 17, 2009
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 033103 | NY | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA01312300 | NJ | Yes |
Addresses
Primary practice location
2510 Belmar Blvd # J1-2
Wall, NJ 07719-3948
Mailing address
605 Main St
Hackensack, NJ 07601-5914
Phone (732) 513-5438
Other providers in Wall, NJ
- Medexpress Urgent Care - New Jersey, Inc
- Sushil K Mehandru
- Catherine L Meli
- Meridian Nursing and Rehabilitation, Inc.
- Matthew R Miller
- Pamela A Minnis
- Modern Dermatology and Cosmetic Center LLC
- Cindy Monsen-Gorto
- Kim H Morales
- New Jersey CVS Pharmacy LLC
All providers in Wall, NJ · Physical Therapist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.