E.M. Dellagatta PT PA

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA00109200 Issued in NJ

Legal business name

E.M. DELLAGATTA PT PA

Practice address

255 Messina Ave
Hammonton, NJ 08037-1327

Phone

(609) 561-1974

Fax

(609) 567-3148

NPI assigned

May 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Enrico Michael Dellagatta, M.ED, DPTNPI 1700069564

Title

Ceo

Phone

(609) 561-1974

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Maple Leaf Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Enrico Michael Dellagatta, PT

  • Specialist
  • Hammonton, NJ
  • NPI 1700069564

  Physical Therapist

  Medicare reassignment NPD Authorized official
• Jack Thomas Egan

  • Physical Therapist
  • Hammonton, NJ
  • NPI 1730730003
  Medicare reassignment NPD

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1972716769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 MESSINA AVE",
            "address_2": "PO BOX 663",
            "city": "HAMMONTON",
            "state": "NJ",
            "postal_code": "080371327",
            "telephone_number": "609-561-1974",
            "fax_number": "609-567-3148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 MESSINA AVE",
            "city": "HAMMONTON",
            "state": "NJ",
            "postal_code": "080371327",
            "telephone_number": "609-561-1974",
            "fax_number": "609-567-3148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E.M. DELLAGATTA PT PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "DELLAGATTA",
        "authorized_official_first_name": "ENRICO",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "609-561-1974",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.ED, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00109200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1709594",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "67001",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3K4079",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "055839",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maple Leaf Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vamsee Duggirala
• Kenneth F Duncan, BS
• Mariah Duphiney, LCSW
• Helen Durham
• Elizabeth M Dyer, NP-C
• Hope M Eccleston, BA
• Jeanne Echols, MSW
• Jack Thomas Egan
• Elite Medical Services Express LLC
• Matthew Ellison

• Physical Therapist in Hammonton, NJ
• Providers in Hammonton, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.