Provider Demographics
NPI:1861575250
Name:URBANO, ROGELIO BONSOL JR (PT)
Entity type:Individual
Prefix:
First Name:ROGELIO
Middle Name:BONSOL
Last Name:URBANO
Suffix:JR
Gender:M
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:PO BOX 95
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-0095
Mailing Address - Country:US
Mailing Address - Phone:848-466-6011
Mailing Address - Fax:888-685-8722
Practice Address - Street 1:38 SENNA DRIVE
Practice Address - Street 2:ROGELIO URBANO JR
Practice Address - City:PARLIN
Practice Address - State:NJ
Practice Address - Zip Code:08859
Practice Address - Country:US
Practice Address - Phone:848-467-6991
Practice Address - Fax:888-685-8722
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPT40QA01068000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist