Provider Demographics
NPI:1831327741
Name:BECK, JONATHAN RAYMOND (PT, DPT, SCS)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:RAYMOND
Last Name:BECK
Suffix:
Gender:M
Credentials:PT, DPT, SCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:11 EAGLE ROCK AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936-3167
Mailing Address - Country:US
Mailing Address - Phone:973-887-9000
Mailing Address - Fax:973-887-3816
Practice Address - Street 1:197 RIDGEDALE AVE STE 155
Practice Address - Street 2:
Practice Address - City:CEDAR KNOLLS
Practice Address - State:NJ
Practice Address - Zip Code:07927-2198
Practice Address - Country:US
Practice Address - Phone:973-605-5115
Practice Address - Fax:973-605-5995
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPT019996225100000X
NJ40QA01371900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist