Provider Demographics
NPI:1003964230
Name:BURNS, VANESSA LYNN (DPT)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:LYNN
Last Name:BURNS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 ROUTE 28
Mailing Address - Street 2:SUITE 207
Mailing Address - City:RARITAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08869-1354
Mailing Address - Country:US
Mailing Address - Phone:908-252-9900
Mailing Address - Fax:908-252-9901
Practice Address - Street 1:575 ROUTE 28
Practice Address - Street 2:SUITE 207
Practice Address - City:RARITAN
Practice Address - State:NJ
Practice Address - Zip Code:08869-1354
Practice Address - Country:US
Practice Address - Phone:908-252-9900
Practice Address - Fax:908-252-9901
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01231200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist