Provider Demographics
NPI:1225363807
Name:BRAUER, NANCY P (PT, DPT)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:P
Last Name:BRAUER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:M
Other - Last Name:PHELPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:200 SOMERSET STREET
Mailing Address - Street 2:PHYSICAL THERAPY DEPARTMENT
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 SOMERSET STREET
Practice Address - Street 2:PHYSICAL THERAPY DEPARTMENT
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901
Practice Address - Country:US
Practice Address - Phone:732-258-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01333600225100000X
NY024527225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist