Provider Demographics
NPI:1528080587
Name:ZAFFARESE, STEVEN G (PT)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:G
Last Name:ZAFFARESE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 ROUTE 130 SOUTH
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-2509
Mailing Address - Country:US
Mailing Address - Phone:609-918-0600
Mailing Address - Fax:609-918-0601
Practice Address - Street 1:400 US HIGHWAY 130
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-2792
Practice Address - Country:US
Practice Address - Phone:609-947-0542
Practice Address - Fax:609-947-0542
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00840000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ104939Medicare PIN