Provider Demographics
NPI:1902051584
Name:CHECCA, JOAN BALDWIN (RPT)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:BALDWIN
Last Name:CHECCA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:599 UPPER MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-1622
Mailing Address - Country:US
Mailing Address - Phone:973-783-8091
Mailing Address - Fax:
Practice Address - Street 1:599 UPPER MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-1622
Practice Address - Country:US
Practice Address - Phone:973-783-8091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA090692251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics