Provider Demographics
NPI:1033105010
Name:PAUL, BRIAN PHILIP (MSPT)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:PHILIP
Last Name:PAUL
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 ROUTE 520
Mailing Address - Street 2:SUITE C
Mailing Address - City:ENGLISHTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-8217
Mailing Address - Country:US
Mailing Address - Phone:732-972-5565
Mailing Address - Fax:732-972-5562
Practice Address - Street 1:14 ROUTE 520
Practice Address - Street 2:SUITE C
Practice Address - City:ENGLISHTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8217
Practice Address - Country:US
Practice Address - Phone:732-972-5565
Practice Address - Fax:732-972-5562
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA09446225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist