Provider Demographics
NPI:1366414336
Name:BATEMAN, DANETA D (PT)
Entity type:Individual
Prefix:MRS
First Name:DANETA
Middle Name:D
Last Name:BATEMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MCCATHARN RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NJ
Mailing Address - Zip Code:08833-4102
Mailing Address - Country:US
Mailing Address - Phone:908-236-6110
Mailing Address - Fax:
Practice Address - Street 1:427 HOMESTEAD RD
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-1400
Practice Address - Country:US
Practice Address - Phone:908-281-6515
Practice Address - Fax:908-281-6269
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00136100208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ089153TXQMedicare ID - Type Unspecified