Provider Demographics
NPI:1548266042
Name:BAY-SEA PHYSICAL THERAPY OF VINELAND PA
Entity type:Organization
Organization Name:BAY-SEA PHYSICAL THERAPY OF VINELAND PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSCEMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-455-9730
Mailing Address - Street 1:232 LAUREL HEIGHTS DR
Mailing Address - Street 2:BLDG 4
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-3634
Mailing Address - Country:US
Mailing Address - Phone:856-455-9730
Mailing Address - Fax:856-455-5165
Practice Address - Street 1:2848 S DELSEA DR
Practice Address - Street 2:BLDG 3
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-7042
Practice Address - Country:US
Practice Address - Phone:856-696-0404
Practice Address - Fax:856-696-8555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-21
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
56002OtherCIGNA
56002OtherCIGNA