Provider Demographics
NPI:1154616019
Name:PENALES-CEMPRON, FRITZIE ANN (PT, DPT)
Entity type:Individual
Prefix:
First Name:FRITZIE ANN
Middle Name:
Last Name:PENALES-CEMPRON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 CARTER RD
Mailing Address - Street 2:
Mailing Address - City:HASKELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07420-1062
Mailing Address - Country:US
Mailing Address - Phone:862-200-7120
Mailing Address - Fax:
Practice Address - Street 1:182 CARTER RD
Practice Address - Street 2:
Practice Address - City:HASKELL
Practice Address - State:NJ
Practice Address - Zip Code:07420-1062
Practice Address - Country:US
Practice Address - Phone:862-200-7120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist