Amy Rae Stark, PT
Physical Therapist in Edison, NJ. Individual provider (NPI-1).
NPI number1831761840
StatusActive
Last updated in NPPESJul 11, 2021
Details
- NPI
- 1831761840
- Entity type
- Individual (NPI-1)
- Name
- Amy Rae Stark
- Credential
- PT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 11, 2021
- Certification date
- Jul 11, 2021
- Last updated
- Jul 11, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 40QS00305100 | NJ | Yes |
Practice location
3 Stephenville Pkwy Ste 2cEdison, NJ 08820-3061
Phone 908-293-8636
Mailing address
25 Goodale CirNew Brunswick, NJ 08901-1607
Phone 908-202-0701
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