Provider Demographics
NPI:1053545392
Name:GRUNDEL, ALANA NAOMI (DPT)
Entity type:Individual
Prefix:MS
First Name:ALANA
Middle Name:NAOMI
Last Name:GRUNDEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 OAK BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08512-3013
Mailing Address - Country:US
Mailing Address - Phone:609-443-5288
Mailing Address - Fax:
Practice Address - Street 1:1358 BROAD ST
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-4222
Practice Address - Country:US
Practice Address - Phone:973-249-0249
Practice Address - Fax:973-249-0251
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01299400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist