Provider Demographics
NPI:1073637096
Name:FLORES, AUGUST A (PT)
Entity Type:Individual
Prefix:MR
First Name:AUGUST
Middle Name:A
Last Name:FLORES
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 1:350 BALDWIN RD
Mailing Address - Street 2:APT S13
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-2004
Mailing Address - Country:US
Mailing Address - Phone:973-943-2652
Mailing Address - Fax:
Practice Address - Street 1:40 WATCHUNG WAY
Practice Address - Street 2:
Practice Address - City:BERKELEY HTS
Practice Address - State:NJ
Practice Address - Zip Code:07922-2600
Practice Address - Country:US
Practice Address - Phone:908-771-5788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00899700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist