Provider Demographics
NPI:1316919285
Name:BEIDLER, JOHN K (PT/ATC)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:K
Last Name:BEIDLER
Suffix:
Gender:M
Credentials:PT/ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2273 ROUTE 33
Mailing Address - Street 2:202
Mailing Address - City:HAMILTON SQUARE
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-1747
Mailing Address - Country:US
Mailing Address - Phone:609-586-3322
Mailing Address - Fax:609-586-9094
Practice Address - Street 1:2273 ROUTE 33
Practice Address - Street 2:202
Practice Address - City:HAMILTON SQUARE
Practice Address - State:NJ
Practice Address - Zip Code:08690-1747
Practice Address - Country:US
Practice Address - Phone:609-586-3322
Practice Address - Fax:609-586-9094
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA02435225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ751892CRXMedicare PIN