Basic Information
| Provider Information | |||||||||
| NPI: | 1780797696 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | JALD INC | ||||||||
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| OtherOrganizationName: | DI SABATINO PHYSICAL THERAPY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 444 HURFFVILLE CROSS KEYS RD | ||||||||
| Address2: | CROSS KEYS PLAZA | ||||||||
| City: | SEWELL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08080 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8565828000 | ||||||||
| FaxNumber: | 8565828319 | ||||||||
| Practice Location | |||||||||
| Address1: | 444 HURFFVILLE CROSS KEYS RD | ||||||||
| Address2: | CROSS KEYS PLAZA | ||||||||
| City: | SEWELL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08080 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8565828000 | ||||||||
| FaxNumber: | 8565828319 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2006 | ||||||||
| LastUpdateDate: | 10/05/2012 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | DI SABATINO | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
| AuthorizedOfficialMiddleName: | JOSEPH | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 8565828000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | PT | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 40QA00223000 | NJ | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.