Joseph Rennold Whiting, | |
104 Chestnut St, Ridgewood, NJ 07450-2502 | |
(201) 493-8111 | |
Not Available |
Full Name | Joseph Rennold Whiting |
---|---|
Gender | Male |
Speciality | Physical Therapist - Orthopedic |
Location | 104 Chestnut St, Ridgewood, 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 |
---|---|---|---|
1962265926 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2251X0800X | Physical Therapist - Orthopedic | 40QA02235200 (New Jersey) | Primary |
Provider Name | Ridgewood Physical Therapy And Rehabilitation Center Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1548340052 PECOS PAC ID: 1850349820 Enrollment ID: O20050106000192 |
Mailing Address | Practice Location Address |
---|---|
Joseph Rennold Whiting, 210 S Van Dien Ave, Ridgewood, NJ 07450-5216 Ph: (201) 753-8835 | Joseph Rennold Whiting, 104 Chestnut St, Ridgewood, NJ 07450-2502 Ph: (201) 493-8111 |
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