Robert D Bazley, PT

Individual provider Active NPI Physical Therapist · West Long Branch, NJ

NPI 1992789622 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1992789622
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
QA02727 (NJ)
Practice address
16 Cooper Ave
West Long Branch, NJ 07764-1214
Phone
(732) 263-9474
Fax
(732) 263-9475
NPI assigned
Dec 6, 2005
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Bazley Physical Therapy Associates Physical Therapist Past Accepting new patients
Eastern Monmouth Physical Therapy LLC Physical Therapist Past
since Jan 8, 2003
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X QA02727 NJ Yes

Addresses

Primary practice location

16 Cooper Ave
West Long Branch, NJ 07764-1214

Mailing address

16 Cooper Ave
West Long Branch, NJ 07764-1214
Phone (732) 263-9474

Other providers in West Long Branch, NJ

All providers in West Long Branch, NJ · Physical Therapist in New Jersey

Sources for this page

Verify at the official NPI Registry.