Provider Demographics
NPI:1538365226
Name:ANDERSON, ELLEN Z (PT)
Entity type:Individual
Prefix:PROF
First Name:ELLEN
Middle Name:Z
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:791 LAMBERTS MILL RD
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-4735
Mailing Address - Country:US
Mailing Address - Phone:908-654-1371
Mailing Address - Fax:908-789-1354
Practice Address - Street 1:791 LAMBERTS MILL RD
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-4735
Practice Address - Country:US
Practice Address - Phone:908-654-1371
Practice Address - Fax:908-789-1354
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00275800225100000X, 2251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics