Provider Demographics
NPI:1104049907
Name:HANSFORD, TERRI (MA,PT,CHT)
Entity type:Individual
Prefix:MS
First Name:TERRI
Middle Name:
Last Name:HANSFORD
Suffix:
Gender:F
Credentials:MA,PT,CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 ROUTE 130 STE 1A
Mailing Address - Street 2:
Mailing Address - City:BORDENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08505-2249
Mailing Address - Country:US
Mailing Address - Phone:609-324-9320
Mailing Address - Fax:609-324-9430
Practice Address - Street 1:163 ROUTE 130 STE 1A
Practice Address - Street 2:
Practice Address - City:BORDENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08505-2249
Practice Address - Country:US
Practice Address - Phone:609-324-9320
Practice Address - Fax:609-324-9430
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01303800225100000X, 2251H1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT121580Medicare ID - Type Unspecified