Provider Demographics
NPI:1316645690
Name:O'MALLEY, ASHLEIGH NICOLE (DPT)
Entity type:Individual
Prefix:DR
First Name:ASHLEIGH
Middle Name:NICOLE
Last Name:O'MALLEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 NORTH VILLAGE BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871
Mailing Address - Country:US
Mailing Address - Phone:862-299-3300
Mailing Address - Fax:
Practice Address - Street 1:10 NORTH VILLAGE BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871
Practice Address - Country:US
Practice Address - Phone:862-299-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02154200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist