Provider Demographics
NPI:1932926110
Name:KAPLAN, JUSTIN MATTHEW
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:MATTHEW
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2145 NJ-35 N
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733
Mailing Address - Country:US
Mailing Address - Phone:732-490-2860
Mailing Address - Fax:
Practice Address - Street 1:2145 NJ-35 N
Practice Address - Street 2:SUITE 24
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733
Practice Address - Country:US
Practice Address - Phone:732-490-2860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02291800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist