Individual provider · NPI-1

Rosauro Mendoza Aquino, PT

Physical Therapist · Fair Lawn, NJ

NPI number1295809135
StatusActive
Last updated in NPPESSep 8, 2018

Details

NPI
1295809135
Entity type
Individual (NPI-1)
Name
Mr. Rosauro Mendoza Aquino
Credential
PT
Sex
Male
Sole proprietor
Yes
Enumeration date
Nov 20, 2006
Last updated
Sep 8, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225100000X Physical Therapist40QA00997600NJYes
225100000X Physical Therapist022156-1NY

Practice location

28-12 Broadway
Fair Lawn, NJ 07410-3924

Phone 201-475-8482

Mailing address

28 Crossgate Rd Fl 1
Jersey City, NJ 07305-1206

Phone 201-779-4393

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