Provider Demographics
NPI:1053892265
Name:COLANGELO, SALVATORE P (DPT)
Entity type:Individual
Prefix:MR
First Name:SALVATORE
Middle Name:P
Last Name:COLANGELO
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 1:1072 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:STIRLING
Mailing Address - State:NJ
Mailing Address - Zip Code:07980-1518
Mailing Address - Country:US
Mailing Address - Phone:908-903-1199
Mailing Address - Fax:908-901-1188
Practice Address - Street 1:1072 VALLEY RD
Practice Address - Street 2:
Practice Address - City:STIRLING
Practice Address - State:NJ
Practice Address - Zip Code:07980-1518
Practice Address - Country:US
Practice Address - Phone:908-903-1199
Practice Address - Fax:908-901-1188
Is Sole Proprietor?:No
Enumeration Date:2018-08-25
Last Update Date:2018-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01815600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist