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DEMETRI DIMITRIADIS PT, DPT
Orthopedic >> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1427336197
Individual Registrant: DEMETRI DIMITRIADIS PT, DPT
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
75 OAK ST NORWOOD, NJ 07648-1394 US
Tel: 201-588-6290 Fax: 201-588-6059
Tel: 201-588-6290 Fax: 201-588-6059
Contact information for business:
1021 KINGSLAND LN FORT LEE, NJ 07024-1528 US
Tel: (20-1) -588-6290 Fax: 201-588-6059
Tel: (20-1) -588-6290 Fax: 201-588-6059
Registration Information:
NPI: 1427336197
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 2251X0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapist Orthopedic | NJ | 40QA01409300 |
| Y | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapist | NJ | 40QA01409300 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
