Jesse Christian Pedersen, | |
57 Lower Matchaponix Ave, Monroe, NJ 08831-1443 | |
(732) 570-8598 | |
Not Available |
Full Name | Jesse Christian Pedersen |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 57 Lower Matchaponix Ave, Monroe, 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 |
---|---|---|---|
1174249908 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 40QA02132700 (New Jersey) | Primary |
Provider Name | Benchmark Physical Therapy Of Oregon Llc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1801257191 PECOS PAC ID: 0143510602 Enrollment ID: O20160613001008 |
Mailing Address | Practice Location Address |
---|---|
Jesse Christian Pedersen, 57 Lower Matchaponix Ave, Monroe, NJ 08831-1443 Ph: (732) 570-8598 | Jesse Christian Pedersen, 57 Lower Matchaponix Ave, Monroe, NJ 08831-1443 Ph: (732) 570-8598 |
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