Provider Demographics
NPI:1306269071
Name:ABDULLAH, CINDERELLA
Entity type:Individual
Prefix:
First Name:CINDERELLA
Middle Name:
Last Name:ABDULLAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 MILL ST
Mailing Address - Street 2:H3
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-5318
Mailing Address - Country:US
Mailing Address - Phone:877-268-9100
Mailing Address - Fax:
Practice Address - Street 1:1600 SAINT GEORGES AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-2764
Practice Address - Country:US
Practice Address - Phone:732-428-5566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01538200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist