Active NPI
Justin Andronico
- Physical Therapist
- Medford, NJ
National Provider Identifier
1548788920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA01752800
- Practice address
- 200 Tuckerton Rd Ste 17
Medford, NJ 08055-8806 - Phone
- (856) 396-2250
- NPI assigned
- Sep 6, 2017
- Sex
- Male
- 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 Therapist | 225100000X | 40QA01752800 | NJ | Primary |
Addresses
Primary practice location
200 Tuckerton Rd Ste 17
Medford, NJ 08055-8806
Mailing address
546 S 3Rd St
Hammonton, NJ 08037-1437
Phone (609) 377-6151
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA01752800 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504656000000",
"number": "1548788920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "546 S 3RD ST",
"city": "HAMMONTON",
"state": "NJ",
"postal_code": "080371437",
"telephone_number": "609-377-6151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 TUCKERTON RD STE 17",
"city": "MEDFORD",
"state": "NJ",
"postal_code": "080558806",
"telephone_number": "856-396-2250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDRONICO",
"first_name": "JUSTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-06",
"last_updated": "2017-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA01752800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, NJ
- Ambrosia of Medford LLC (Pinelands Recovery Center of Medford)
- Ambrosia of Medford LLC (Pinelands Recovery Center of Medford)
- Ambrosia of New Jersey LLC (Pinelands Recovery Center of Medford)
- Elizabeth Backer Amisson, MS, RD, CDE
- Meaghan Marie Andre-Brown, D.O.
- Jessica Kristi Angelone
- Barbara Scaff Angstadt, MSW
- Lauren Antunes
- Apex Acupuncture Group
- Archway Programs
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.