Provider Demographics
NPI:1275369225
Name:DONOGHUE, ERIN (PT, DPT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:DONOGHUE
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 1:600 ASHBERRY CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-2126
Mailing Address - Country:US
Mailing Address - Phone:856-912-4168
Mailing Address - Fax:
Practice Address - Street 1:1572 US-206
Practice Address - Street 2:YATES PLAZA, SUITE 4
Practice Address - City:TABERNACLE
Practice Address - State:NJ
Practice Address - Zip Code:08088-8882
Practice Address - Country:US
Practice Address - Phone:609-388-4391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA022855002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic