Provider Demographics
NPI:1215127659
Name:BALDOVINO, ELOISA C (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:ELOISA
Middle Name:C
Last Name:BALDOVINO
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:757 TEANECK ROAD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666
Mailing Address - Country:US
Mailing Address - Phone:201-833-2288
Mailing Address - Fax:201-833-4441
Practice Address - Street 1:757 TEANECK ROAD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666
Practice Address - Country:US
Practice Address - Phone:201-833-2288
Practice Address - Fax:201-833-4441
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01053500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist