Basic Information
Provider Information
NPI: 1295453694
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: UNSON
FirstName: AARON
MiddleName: CHRISTOPHER
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 981 US HIGHWAY 22 FL 2
Address2:  
City: BRIDGEWATER
State: NJ
PostalCode: 088072946
CountryCode: US
TelephoneNumber: 2018017141
FaxNumber:  
Practice Location
Address1: 1414 NEWKIRK AVE STE 1
Address2:  
City: BROOKLYN
State: NY
PostalCode: 112266669
CountryCode: US
TelephoneNumber: 7184344311
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/22/2022
LastUpdateDate: 08/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/21/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X049211NYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home