Provider Demographics
NPI:1043403264
Name:NEAL, DONNA P (PTA)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:P
Last Name:NEAL
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 1:730 PARK AVE
Mailing Address - Street 2:29
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-1603
Mailing Address - Country:US
Mailing Address - Phone:908-791-0182
Mailing Address - Fax:
Practice Address - Street 1:9020 WALL ST
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-6011
Practice Address - Country:US
Practice Address - Phone:201-861-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00255600225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant