Provider Demographics
NPI:1679789515
Name:GASPAR, NOEL (PT)
Entity type:Individual
Prefix:MR
First Name:NOEL
Middle Name:
Last Name:GASPAR
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 1:18 STOCKTON LN
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-6408
Mailing Address - Country:US
Mailing Address - Phone:609-645-0485
Mailing Address - Fax:609-645-0485
Practice Address - Street 1:18 STOCKTON LN
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-6408
Practice Address - Country:US
Practice Address - Phone:609-645-0485
Practice Address - Fax:609-645-0485
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01162000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist