Provider Demographics
NPI:1588706683
Name:GAVER, REBECCA (PT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:GAVER
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 1:72 LITTLE SILVER PKWY
Mailing Address - Street 2:
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739-1119
Mailing Address - Country:US
Mailing Address - Phone:732-721-4808
Mailing Address - Fax:732-721-1646
Practice Address - Street 1:1044 US HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:PARLIN
Practice Address - State:NJ
Practice Address - Zip Code:08859-1401
Practice Address - Country:US
Practice Address - Phone:732-721-4808
Practice Address - Fax:732-721-1646
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00856100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist