Provider Demographics
NPI:1962754283
Name:HARDY, NICOLE (DPT)
Entity type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:
Last Name:HARDY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 FAIRVIEW DR
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-4532
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 DENOW RD
Practice Address - Street 2:SUITE U
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-5246
Practice Address - Country:US
Practice Address - Phone:609-737-8130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-10
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01456700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist