Gardner, Justin
Gardner, Justin is an individual health care provider with primary practice located at 1719 Main St , Lake Como NJ 07719-3097. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Gardner, Justin can be contacted via phone (732) 894-9200.Contact Information
Primary practice address
1719 Main St
Lake Como NJ 07719-3097
Phone: (732) 894-9200
Fax: (732) 894-9202
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 40QA01718800 | New Jersey |
Profile Details
| NPI number | 1528508041 |
|---|---|
| LBN Legal business name | Gardner, Justin |
| Credentials | PT, DPT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 2nd, 2017 |
| Last updated | Mar 2nd, 2017 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528508041 | NPPES |
| New Jersey | Other | 40QA01718800 | PT LICENSE |
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