Provider Demographics
NPI:1699053389
Name:PERRONE, ANTHONY J (DPT, PT)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:J
Last Name:PERRONE
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 MAIN ST
Mailing Address - Street 2:STE E
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-2621
Mailing Address - Country:US
Mailing Address - Phone:732-970-4974
Mailing Address - Fax:732-970-4088
Practice Address - Street 1:127 MAIN ST
Practice Address - Street 2:STE E
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-2621
Practice Address - Country:US
Practice Address - Phone:732-970-4974
Practice Address - Fax:732-970-4088
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-28
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01408600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist