Active NPI
Mary L Denardo, PTA
- Physical Therapy Assistant
- Phillipsburg, NJ
National Provider Identifier
1467679340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- QB0000671
- Practice address
- 390 Red School LN
Phillipsburg, NJ 08865-2230 - Phone
- (908) 859-0200
- NPI assigned
- Apr 20, 2007
- Last updated
- Jul 8, 2007
- 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 Therapy Assistant | 225200000X | QB0000671 | NJ | Primary |
Addresses
Primary practice location
390 Red School LN
Phillipsburg, NJ 08865-2230
Mailing address
5501 Hale Ave
Bethlehem, PA 18017-9036
Phone (610) 868-1674
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 |
|---|---|---|---|
| QB0000671 | NJ | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467679340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5501 HALE AVE",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "180179036",
"telephone_number": "610-868-1674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "390 RED SCHOOL LN",
"city": "PHILLIPSBURG",
"state": "NJ",
"postal_code": "088652230",
"telephone_number": "908-859-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENARDO",
"first_name": "MARY",
"middle_name": "L",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NJ",
"license": "QB0000671",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phillipsburg, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.