Provider Demographics
NPI:1043480486
Name:JANI, MARYLOUISE (PT)
Entity Type:Individual
Prefix:MS
First Name:MARYLOUISE
Middle Name:
Last Name:JANI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 OVERLOOK WAY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-4839
Mailing Address - Country:US
Mailing Address - Phone:609-620-1817
Mailing Address - Fax:
Practice Address - Street 1:800 DENOW RD
Practice Address - Street 2:SUITE U
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-5246
Practice Address - Country:US
Practice Address - Phone:609-737-8130
Practice Address - Fax:609-737-8131
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA008742002251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics