Provider Demographics
NPI:1447995519
Name:VERNER, ANJALI (PTA)
Entity type:Individual
Prefix:
First Name:ANJALI
Middle Name:
Last Name:VERNER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 HARDING AVE
Mailing Address - Street 2:
Mailing Address - City:PARLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08859-1546
Mailing Address - Country:US
Mailing Address - Phone:732-725-2535
Mailing Address - Fax:
Practice Address - Street 1:3562 ROUTE NJ-27
Practice Address - Street 2:SUITE 124
Practice Address - City:KENDALL PARK
Practice Address - State:NJ
Practice Address - Zip Code:08824-1005
Practice Address - Country:US
Practice Address - Phone:732-853-8177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00378300225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant