Provider Demographics
NPI:1679707491
Name:MAGPANTAY, DENNISS ADAJAR (PT)
Entity type:Individual
Prefix:MR
First Name:DENNISS
Middle Name:ADAJAR
Last Name:MAGPANTAY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 S WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-2328
Mailing Address - Country:US
Mailing Address - Phone:201-892-3629
Mailing Address - Fax:
Practice Address - Street 1:11 S WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-2328
Practice Address - Country:US
Practice Address - Phone:201-892-3629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ40QA01415600225100000X
MEPT3252225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist