Provider Demographics
NPI:1902944903
Name:SPADAFORA, TIFFANY (PT)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:
Last Name:SPADAFORA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 US HIGHWAY 9
Mailing Address - Street 2:PROFESSIONAL SPORTS & ORTHOPAEDIC REHABILITATION
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-8274
Mailing Address - Country:US
Mailing Address - Phone:732-617-8090
Mailing Address - Fax:732-972-5458
Practice Address - Street 1:455 US HIGHWAY 9
Practice Address - Street 2:PROFESSIONAL SPORTS & ORTHOPAEDIC REHABILITATION
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8274
Practice Address - Country:US
Practice Address - Phone:732-617-8090
Practice Address - Fax:732-972-5458
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ40QA01156900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist