Provider Demographics
NPI:1306059126
Name:BOWE, MARIA CECILIA (RPT)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:CECILIA
Last Name:BOWE
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:MARICEL
Other - Middle Name:
Other - Last Name:BOWE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPT
Mailing Address - Street 1:16 WHIPPOORWILL LN
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866-4222
Mailing Address - Country:US
Mailing Address - Phone:973-784-4202
Mailing Address - Fax:973-822-8311
Practice Address - Street 1:415 SOUTHERN BLVD
Practice Address - Street 2:KING JAMES CARE CENTER
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-1488
Practice Address - Country:US
Practice Address - Phone:973-822-8311
Practice Address - Fax:973-822-8311
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00870000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist