Provider Demographics
NPI:1962958652
Name:EILBACHER, DAVID (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:EILBACHER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 POWELSON DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-2235
Mailing Address - Country:US
Mailing Address - Phone:908-285-4138
Mailing Address - Fax:
Practice Address - Street 1:135 US HIGHWAY 46
Practice Address - Street 2:
Practice Address - City:BUDD LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07828-2546
Practice Address - Country:US
Practice Address - Phone:973-620-8526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01680900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ40QA01680900Medicaid
NJ40QA01680900Medicare Oscar/Certification
NJ40QA01680900Medicaid
NJ40QA01680900Medicare UPIN