Active NPI
Nicole M. Hauck, DPT
- Physical Therapist
- West Orange, NJ
National Provider Identifier
1447627609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA01561900
- Practice address
- 1500 Pleasant Valley Way
West Orange, NJ 07052 - Phone
- (973) 325-3422
- Fax
- (973) 325-0825
- NPI assigned
- Aug 24, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA01561900 | NJ | Primary |
Addresses
Primary practice location
1500 Pleasant Valley Way
West Orange, NJ 07052
Mailing address
42 Fairfield Place
West Caldwell, NJ 07006
Phone (973) 575-4500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA01561900 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440374400000",
"number": "1447627609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42 FAIRFIELD PLACE",
"city": "WEST CALDWELL",
"state": "NJ",
"postal_code": "07006",
"telephone_number": "973-575-4500",
"fax_number": "973-575-4501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 PLEASANT VALLEY WAY",
"city": "WEST ORANGE",
"state": "NJ",
"postal_code": "07052",
"telephone_number": "973-325-3422",
"fax_number": "973-325-0825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAUCK",
"first_name": "NICOLE",
"middle_name": "M.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-24",
"last_updated": "2015-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA01561900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Orange, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.