Provider Demographics
NPI:1114922408
Name:TREZZA, THOMAS J (MSPT, DPT)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:TREZZA
Suffix:
Gender:M
Credentials:MSPT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 MADISON AVE
Mailing Address - Street 2:STE 130
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6967
Mailing Address - Country:US
Mailing Address - Phone:973-292-1101
Mailing Address - Fax:973-292-4149
Practice Address - Street 1:101 MADISON AVE
Practice Address - Street 2:STE 205
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7305
Practice Address - Country:US
Practice Address - Phone:973-292-1101
Practice Address - Fax:973-292-4149
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00543300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ783129PCNMedicare ID - Type Unspecified