Basic Information
| Provider Information | |||||||||
| NPI: | 1104257542 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DELISI | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | |||||||||
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| Credential: | PT, DPT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | FURRER | ||||||||
| OtherFirstName: | REBECCA | ||||||||
| OtherMiddleName: | L | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 224 STRAWBRIDGE DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | MOORESTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080574602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8566774000 | ||||||||
| FaxNumber: | 8562343014 | ||||||||
| Practice Location | |||||||||
| Address1: | 8008 ROUTE 130 STE 100 | ||||||||
| Address2: | |||||||||
| City: | DELRAN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080751869 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8564619393 | ||||||||
| FaxNumber: | 8568241407 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2013 | ||||||||
| LastUpdateDate: | 07/03/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 40QA01527400 | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.