John Thomas Diffily, PT

Individual provider Active NPI Physical Therapist · Branchville, NJ

NPI 1497976856 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1497976856
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
40QA00185100 (NJ)
Practice address
403 Pidgeon Hill Rd
Branchville, NJ 07826-5701
Phone
(973) 875-3209
Fax
(973) 875-6458
NPI assigned
May 2, 2007
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)
No

State licenses

LicenseStateTypeSpecialty
40QA00185100NJMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA00185100 NJ Yes

Addresses

Primary practice location

403 Pidgeon Hill Rd
Branchville, NJ 07826-5701

Mailing address

403 Pidgeon Hill Rd
Branchville, NJ 07826-5701
Phone (973) 875-3209

Other providers in Branchville, NJ

All providers in Branchville, NJ · Physical Therapist in New Jersey

Sources for this page

Verify at the official NPI Registry.