Provider Demographics
NPI:1053195438
Name:FREHILL, CONOR (DPT)
Entity type:Individual
Prefix:
First Name:CONOR
Middle Name:
Last Name:FREHILL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 LENAPE RD
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07821-4589
Mailing Address - Country:US
Mailing Address - Phone:973-786-6045
Mailing Address - Fax:973-786-6054
Practice Address - Street 1:8 LENAPE RD
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:NJ
Practice Address - Zip Code:07821-4589
Practice Address - Country:US
Practice Address - Phone:973-786-6045
Practice Address - Fax:973-786-6054
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02204300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist