Provider Demographics
NPI:1548436074
Name:BREGMAN, WENDY SUE
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:SUE
Last Name:BREGMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:SUE
Other - Last Name:BREGMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:756 KIMBALL AVE
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-1956
Mailing Address - Country:US
Mailing Address - Phone:908-654-1780
Mailing Address - Fax:
Practice Address - Street 1:756 KIMBALL AVE
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-1956
Practice Address - Country:US
Practice Address - Phone:908-654-1780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00003612225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist