Provider Demographics
NPI:1316797947
Name:ABAPO, THERESA (DPT)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:ABAPO
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 1:1500 MEETING HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:SEA GIRT
Mailing Address - State:NJ
Mailing Address - Zip Code:08750-2220
Mailing Address - Country:US
Mailing Address - Phone:732-784-6545
Mailing Address - Fax:732-240-5280
Practice Address - Street 1:395 ROUTE 70
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-6161
Practice Address - Country:US
Practice Address - Phone:732-905-7818
Practice Address - Fax:732-905-7754
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02128800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist