Provider Demographics
NPI:1043037088
Name:ANDRADE, SKYLAR ELIZABETH (PT, DPT)
Entity type:Individual
Prefix:
First Name:SKYLAR
Middle Name:ELIZABETH
Last Name:ANDRADE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 YORKSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07480-1624
Mailing Address - Country:US
Mailing Address - Phone:973-668-0601
Mailing Address - Fax:
Practice Address - Street 1:201 PLEASANT HILL RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:NJ
Practice Address - Zip Code:07930-2141
Practice Address - Country:US
Practice Address - Phone:973-252-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02290000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist