Provider Demographics
NPI:1154574861
Name:D'EGIDIO, ROBERT AMERIGO (DPT)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:AMERIGO
Last Name:D'EGIDIO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:928 MEYERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:NJ
Mailing Address - Zip Code:07933-1010
Mailing Address - Country:US
Mailing Address - Phone:908-660-0025
Mailing Address - Fax:
Practice Address - Street 1:182 SOUTH ST STE 7
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-5350
Practice Address - Country:US
Practice Address - Phone:973-540-0046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-25
Last Update Date:2008-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01290400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist