Maple Leaf Physical Therapy PC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

MAPLE LEAF PHYSICAL THERAPY PC

Practice address

257 Messina Ave
Hammonton, NJ 08037-1327

Phone

(609) 561-1974

NPI assigned

Jul 29, 2025

Last updated

Oct 17, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jack T Egan, DPTNPI 1730730003

Title

President

Phone

(609) 417-1312

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jack Thomas Egan

  • Physical Therapist
  • Hammonton, NJ
  • NPI 1730730003
  Medicare reassignment NPD Authorized official
• Enrico Michael Dellagatta, PT

  • Specialist
  • Hammonton, NJ
  • NPI 1700069564
  NPD

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

{
    "created_epoch": "1753747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760659200000",
    "number": "1780567438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 MESSINA AVE",
            "city": "HAMMONTON",
            "state": "NJ",
            "postal_code": "080371327",
            "telephone_number": "609-561-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 MESSINA AVE",
            "city": "HAMMONTON",
            "state": "NJ",
            "postal_code": "080371327",
            "telephone_number": "609-561-1974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE LEAF PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-29",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A",
        "authorized_official_last_name": "EGAN",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "609-417-1312",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamal Mahmud, M.D.
• Main Street Family Medicine, PA
• Jillian Nicole Maisch, OT
• Tiffani Major, DIPLOMA
• Robert Eugene Mann, APN
• Michele Marciano, LCSW, LCADC
• Maria Chiara Carta MD PA (Integrative Neurological Care)
• Heidi Ann Marsh
• Allison Marie Martina, NP
• Raquel Martinez-Alzate

• Physical Therapy Clinic/Center in Hammonton, NJ
• Providers in Hammonton, NJ by specialty
• Physical Therapy Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.