Basic Information
| Provider Information | |||||||||
| NPI: | 1831784024 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PELAEZ | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 224 STRAWBRIDGE DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | MOORESTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080574602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8566774000 | ||||||||
| FaxNumber: | 8562343014 | ||||||||
| Practice Location | |||||||||
| Address1: | 205 WHITE HORSE RD E | ||||||||
| Address2: | |||||||||
| City: | VOORHEES | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080432601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8564352323 | ||||||||
| FaxNumber: | 8564352326 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2021 | ||||||||
| LastUpdateDate: | 04/16/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 40QA01955000 | NJ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.