Provider Demographics
NPI:1730395971
Name:HEALY, TARA JOAN (PT)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:JOAN
Last Name:HEALY
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 1:1003 ARNOLD AVE
Mailing Address - Street 2:APARTMENT 1
Mailing Address - City:POINT PLEASANT BORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-2310
Mailing Address - Country:US
Mailing Address - Phone:732-714-1209
Mailing Address - Fax:
Practice Address - Street 1:2021 STATE ROUTE 35
Practice Address - Street 2:REHAB DEPT.
Practice Address - City:WALL TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07719-3539
Practice Address - Country:US
Practice Address - Phone:732-282-1910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00731400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist