Laurie Boenning, PT, MA
Individual provider Active NPI Physical Therapist · Point Pleasant Boro, NJ
NPI 1801842166 · NPPES record last updated Mar 18, 2011
Key facts
- NPI
- 1801842166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- QA04593 (NJ)
- Practice address
- 2417 Bridge Ave
Point Pleasant Boro, NJ 08742-4334 - Phone
- (732) 701-9320
- Fax
- (732) 701-9321
- NPI assigned
- May 26, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110413000138 | NJ | Practitioner - Physical Therapist in Private Practice | 3476737651 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| QA04593 | NJ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Home Rehabilitation, LLC | Physical Therapist | Current |
Accepting new patients |
| Ipta Clinical, LLC | Physical Therapist | Current |
Accepting new patients |
| 3 Dimensional Physical Therapy - Pelvic Health LLC | Physical Therapist | Past |
Accepting new patients |
Locations
175 Route 70
Ste 19
Medford, NJ 08055
Phone (609) 257-3750
2417 Bridge Ave
Point Pleasant Boro, NJ 08742
Phone (732) 701-9320
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | QA04593 | NJ | Yes |
Addresses
Primary practice location
2417 Bridge Ave
Point Pleasant Boro, NJ 08742-4334
Mailing address
2417 Bridge Ave
Point Pleasant Boro, NJ 08742-4334
Phone (732) 701-9320
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2133806 | Other | NJ | AETNA |
Other providers in Point Pleasant Boro, NJ
- Beaver Dam Healthcare LLC
- Amy Bergquist
- Danielle Bersch
- Emily A Bessemer
- Jay Robert Bloom
- Bozza Dental Group, P.a.
- Leonora Theresa Bradley
- Bridge Integrative Health LLC
- Gina M Brigandi
- Bright Side of the Moon LLC
All providers in Point Pleasant Boro, NJ · Physical Therapist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.