Provider Demographics
NPI:1336218262
Name:HELDERS, MARC GERARD (MA PT)
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:GERARD
Last Name:HELDERS
Suffix:
Gender:M
Credentials:MA PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-1759
Mailing Address - Country:US
Mailing Address - Phone:908-322-3202
Mailing Address - Fax:908-322-3252
Practice Address - Street 1:403 PARK AVE
Practice Address - Street 2:
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076-1759
Practice Address - Country:US
Practice Address - Phone:908-322-3202
Practice Address - Fax:908-322-3252
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA00965600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ086390RU9Medicare ID - Type Unspecified