Andrew Atalla
Physical Therapist in West Orange, NJ. Individual provider (NPI-1).
NPI number1295134468
StatusActive
Last updated in NPPESFeb 13, 2020
Details
- NPI
- 1295134468
- Entity type
- Individual (NPI-1)
- Name
- Andrew Atalla
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 13, 2014
- Certification date
- Feb 13, 2020
- Last updated
- Feb 13, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 40QA01805500 | NJ | Yes |
| 225200000X | Physical Therapy Assistant | 40QB00311300 | NJ |
Practice location
622 Eagle Rock AveSuit 104
West Orange, NJ 07052-2994
Phone 973-669-0078
Mailing address
622 Eagle Rock AveSuit 104
West Orange, NJ 07052-2994
Phone 973-669-0078
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