Provider Demographics
NPI:1073619763
Name:MANGABAT, TWINKLE MARIE (PT)
Entity Type:Individual
Prefix:MS
First Name:TWINKLE
Middle Name:MARIE
Last Name:MANGABAT
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 1:206 MILLBURN AVE
Mailing Address - Street 2:APT. 6C
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1844
Mailing Address - Country:US
Mailing Address - Phone:973-232-6131
Mailing Address - Fax:
Practice Address - Street 1:1085 CRANBURY SOUTH RIVER RD
Practice Address - Street 2:SUITE 2
Practice Address - City:JAMESBURG
Practice Address - State:NJ
Practice Address - Zip Code:08831-3410
Practice Address - Country:US
Practice Address - Phone:609-409-1900
Practice Address - Fax:609-409-2565
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00706200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist