Provider Demographics
NPI:1063489680
Name:CAMBI, PETER J (PT)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:J
Last Name:CAMBI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23-13 ELLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-2937
Mailing Address - Country:US
Mailing Address - Phone:201-703-0656
Mailing Address - Fax:
Practice Address - Street 1:350 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3002
Practice Address - Country:US
Practice Address - Phone:845-634-2460
Practice Address - Fax:845-634-2190
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012877225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY012877OtherLICENSE #
NYQ20Z61OtherEMPIRE BCBS ID
NYQ20Z61OtherEMPIRE BCBS ID