Basic Information
Provider Information
NPI: 1154339174
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MAUTE
FirstName: RHONDA
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: MPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 23204 COLUMBUS RD
Address2:  
City: COLUMBUS
State: NJ
PostalCode: 080221904
CountryCode: US
TelephoneNumber: 6093241200
FaxNumber:  
Practice Location
Address1: 560 STOKES RD
Address2: HEARTLAND REHABILITATION SERVICES OF NEW JERSEY INC
City: MEDFORD
State: NJ
PostalCode: 08055
CountryCode: US
TelephoneNumber: 6097147960
FaxNumber: 6097147961
Other Information
ProviderEnumerationDate: 08/04/2006
LastUpdateDate: 01/21/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X40QA00959500NJY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home