Provider Demographics
NPI:1679542468
Name:SEALANDER, DANA (MPT)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:SEALANDER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 MULFORD LN
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-5401
Mailing Address - Country:US
Mailing Address - Phone:908-281-6789
Mailing Address - Fax:
Practice Address - Street 1:1130 RTE 202
Practice Address - Street 2:BUILDING E STE 2-4
Practice Address - City:RARITAN
Practice Address - State:NJ
Practice Address - Zip Code:08869-1490
Practice Address - Country:US
Practice Address - Phone:908-725-9595
Practice Address - Fax:908-725-9803
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00802600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ40QA00802600OtherMEDICAL LICENSE