Provider Demographics
NPI:1780050757
Name:SOYA, MICHAEL J (PT, DPT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:SOYA
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 1:227 LAUREL AVE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-1913
Mailing Address - Country:US
Mailing Address - Phone:570-313-9438
Mailing Address - Fax:
Practice Address - Street 1:227 LAUREL AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-1913
Practice Address - Country:US
Practice Address - Phone:570-313-9438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01624200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist