Provider Demographics
NPI:1407860877
Name:ALBERT, PHILIP R (PT)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:R
Last Name:ALBERT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 OWENS DR
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-6716
Mailing Address - Country:US
Mailing Address - Phone:908-507-8580
Mailing Address - Fax:
Practice Address - Street 1:784 CHIMNEY ROCK RD
Practice Address - Street 2:SUITE E
Practice Address - City:MARTINSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08836-2237
Practice Address - Country:US
Practice Address - Phone:732-302-1860
Practice Address - Fax:732-302-0881
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00000600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
4818135001OtherCIGNA PPO
NJP-11160387OtherMULTIPLAN
NJ150127QC3Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER