Werner Salvador Bustamante, PT, DPT

Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Dover, NJ

NPI 1780460964 · NPPES record last updated Sep 5, 2023

Key facts

NPI
1780460964
Entity type
Individual (NPI type 1)
Primary specialty
Physical Medicine & Rehabilitation Physician 208100000X
License
40QA02197200 (NJ)
Practice address
600 Mount Pleasant Ave Ste F
Dover, NJ 07801-1621
Phone
(973) 366-4000
NPI assigned
Sep 5, 2023
Sex
Male
Sole proprietor
No

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
40QA02197200NJMDPhysical Medicine & Rehabilitation Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 40QA02197200 NJ Yes

Addresses

Primary practice location

600 Mount Pleasant Ave Ste F
Dover, NJ 07801-1621

Mailing address

600 Mount Pleasant Ave Ste F
Dover, NJ 07801-1621
Phone (973) 366-4000

Other providers in Dover, NJ

All providers in Dover, NJ · Physical Medicine & Rehabilitation Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.