Provider Demographics
NPI:1619602612
Name:PINGHERA, VINCENT (PT, DPT)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:
Last Name:PINGHERA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07646-0019
Mailing Address - Country:US
Mailing Address - Phone:201-568-3355
Mailing Address - Fax:201-568-3350
Practice Address - Street 1:145 PIERMONT RD
Practice Address - Street 2:
Practice Address - City:TENAFLY
Practice Address - State:NJ
Practice Address - Zip Code:07670-1022
Practice Address - Country:US
Practice Address - Phone:201-568-3355
Practice Address - Fax:201-568-3350
Is Sole Proprietor?:No
Enumeration Date:2022-07-22
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02091300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist