Provider Demographics
NPI:1124112941
Name:NASH, MAUREEN E (PT)
Entity type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:E
Last Name:NASH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:E
Other - Last Name:PORTER-NASH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:302 FURLONG CIR
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-8016
Mailing Address - Country:US
Mailing Address - Phone:609-970-3783
Mailing Address - Fax:
Practice Address - Street 1:7815 NW BEACON SQUARE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1345
Practice Address - Country:US
Practice Address - Phone:561-455-4850
Practice Address - Fax:561-995-0138
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT30509225100000X
NJ40QA01218200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist