Charo Balagtas Bodiongan, | |
45 E Madison Ave, Clifton, NJ 07011-2323 | |
(973) 931-1717 | |
Not Available |
Full Name | Charo Balagtas Bodiongan |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 45 E Madison Ave, Clifton, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1891746038 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 40QA00960400 (New Jersey) | Primary |
Provider Name | Seniorcare Rehab, Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1669423000 PECOS PAC ID: 7719901933 Enrollment ID: O20060202000192 |
Mailing Address | Practice Location Address |
---|---|
Charo Balagtas Bodiongan, 109 Birch St, Bloomfield, NJ 07003-4017 Ph: (973) 652-8959 | Charo Balagtas Bodiongan, 45 E Madison Ave, Clifton, NJ 07011-2323 Ph: (973) 931-1717 |
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