Justin Daniel Maher, ATC, PT, DPT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

25MT00168300 Issued in NJ

Practice address

1925 Giants Dr
East Rutherford, NJ 07073-2140

Phone

(201) 935-8111

NPI assigned

Jan 24, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1538407671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 PALSA AVE",
            "city": "ELMWOOD PARK",
            "state": "NJ",
            "postal_code": "074071216",
            "telephone_number": "201-873-0302",
            "fax_number": "201-935-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 GIANTS DR",
            "city": "EAST RUTHERFORD",
            "state": "NJ",
            "postal_code": "070732140",
            "telephone_number": "201-935-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHER",
        "first_name": "JUSTIN",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "ATC, PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-24",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NJ",
            "license": "25MT00168300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seokjae D Lim, O.D.
• Jonathan Lin, PT, DPT, ATC, CSCS
• Rachel Long, L.C.S.W.
• Federico Juan Lucas, LPC
• Anthony Michael Luciano, D.D.S.
• Elisabeth Elaine Maichin, MSC
• Elyssa Martino, MA
• Carolyn Maso, M.A. CCC-SLP
• Taylore Allie Mastbeth
• Maxwell Gear LLC

• Athletic Trainer in East Rutherford, NJ
• Providers in East Rutherford, NJ by specialty
• Athletic Trainer in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; 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.