Provider Demographics
NPI:1023564960
Name:DRAHOS, COLLEEN M (DPT)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:M
Last Name:DRAHOS
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 1:272 US HIGHWAY 206
Mailing Address - Street 2:SUITE 210
Mailing Address - City:FLANDERS
Mailing Address - State:NJ
Mailing Address - Zip Code:07836-9081
Mailing Address - Country:US
Mailing Address - Phone:973-927-3034
Mailing Address - Fax:973-927-2853
Practice Address - Street 1:272 US HIGHWAY 206
Practice Address - Street 2:SUITE 210
Practice Address - City:FLANDERS
Practice Address - State:NJ
Practice Address - Zip Code:07836-9081
Practice Address - Country:US
Practice Address - Phone:973-927-3034
Practice Address - Fax:973-927-2853
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01680800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist