Provider Demographics
NPI:1396166864
Name:HIRSCHHORN, CARLA ROBBIN (PT)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:ROBBIN
Last Name:HIRSCHHORN
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 1:8 WOODCREST TER
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-4653
Mailing Address - Country:US
Mailing Address - Phone:908-770-4747
Mailing Address - Fax:
Practice Address - Street 1:704 GINESI DR
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-1249
Practice Address - Country:US
Practice Address - Phone:732-972-8900
Practice Address - Fax:732-972-8909
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-30
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00412000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9999999996OtherCAQH