Provider Demographics
NPI:1003856055
Name:MILLAR, VIRGINIA J (DPT)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:J
Last Name:MILLAR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10 NADINE BLVD
Mailing Address - Street 2:
Mailing Address - City:OCEAN VIEW
Mailing Address - State:NJ
Mailing Address - Zip Code:08230-1709
Mailing Address - Country:US
Mailing Address - Phone:609-846-4968
Mailing Address - Fax:609-478-2082
Practice Address - Street 1:215 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2192
Practice Address - Country:US
Practice Address - Phone:609-536-4995
Practice Address - Fax:609-478-2082
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA005172002081S0010X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ090271Medicare ID - Type Unspecified