Macmario Decastro
Individual provider Active NPI Physical Therapist · Bridgewater, NJ
NPI 1447895677 · NPPES record last updated Nov 12, 2019
Key facts
- NPI
- 1447895677
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 40QA01889000 (NJ)
- Practice address
- 872 E Main St
Bridgewater, NJ 08807-3395 - Phone
- (877) 407-3422
- Fax
- (877) 407-4329
- NPI assigned
- Nov 12, 2019
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|
| 40QA01889000 | NJ | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA01889000 | NJ | Yes |
Addresses
Primary practice location
872 E Main St
Bridgewater, NJ 08807-3395
Mailing address
7 Carnegie PLZ
Cherry Hill, NJ 08003-1000
Phone (877) 407-3422
Other providers in Bridgewater, NJ
- Jo Ann Limos Daquiz
- Susan Darien
- Jody A. Darwick
- Samantha Davis
- Melissa Day
- Sara Decinque
- Mario James Del Valle
- Michael Delatte
- Ryan Delgado
- Nanci Delos Santos
All providers in Bridgewater, 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 Nov 12, 2019. 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.