Provider Demographics
NPI:1093723025
Name:MONTELEONE, BRENDA (PT)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:
Last Name:MONTELEONE
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 1:444 HERMON DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLINVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08322
Mailing Address - Country:US
Mailing Address - Phone:856-262-9258
Mailing Address - Fax:
Practice Address - Street 1:2630 E CHESTNUT AVE
Practice Address - Street 2:STE C5 HEARTLAND REHABILITATION SERVICES OF NEW JERSEY
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08361
Practice Address - Country:US
Practice Address - Phone:856-692-1483
Practice Address - Fax:856-692-7423
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00583900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist