Individual provider Active NPI

Maureen C Duane-Pfeiffer, PTA

  • Physical Therapy Assistant
  • West Orange, NJ
National Provider Identifier
1477670974
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
QB0054 Issued in NJ
Practice address
1199 Pleasant Valley Way
West Orange, NJ 07052-1424
Phone
(973) 731-3600
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X QB0054 NJ Primary

Addresses

Primary practice location

1199 Pleasant Valley Way
West Orange, NJ 07052-1424

Mailing address

107 Long Hill Dr
Clifton, NJ 07013-2320
Phone (973) 779-3557

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

LicenseStateTypeSpecialty
QB0054NJMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477670974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 LONG HILL DR",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132320",
            "telephone_number": "973-779-3557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 PLEASANT VALLEY WAY",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521424",
            "telephone_number": "973-731-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUANE-PFEIFFER",
        "first_name": "MAUREEN",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "QB0054",
            "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 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.

Verify at the official NPI Registry.