Provider Demographics
NPI:1861753089
Name:UTUK, TONIESHA N (DPT)
Entity type:Individual
Prefix:DR
First Name:TONIESHA
Middle Name:N
Last Name:UTUK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TONIESHA
Other - Middle Name:N
Other - Last Name:HOWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1905 CINNAMINSON AVE
Mailing Address - Street 2:
Mailing Address - City:CINNAMINSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08077-2818
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1905 CINNAMINSON AVE
Practice Address - Street 2:
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-2818
Practice Address - Country:US
Practice Address - Phone:609-248-0844
Practice Address - Fax:609-248-0844
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT00133300225700000X
NJ40QA01440200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist