Provider Demographics
NPI:1144376690
Name:MORAN, TERENCE E (DPT)
Entity Type:Individual
Prefix:
First Name:TERENCE
Middle Name:E
Last Name:MORAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 DOUGLAS COURT
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:NJ
Mailing Address - Zip Code:07461
Mailing Address - Country:US
Mailing Address - Phone:862-266-6669
Mailing Address - Fax:
Practice Address - Street 1:2024 MACOPIN RD
Practice Address - Street 2:SUITE E
Practice Address - City:WEST MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07480-1900
Practice Address - Country:US
Practice Address - Phone:973-728-5588
Practice Address - Fax:973-728-0928
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01121500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ086428QXCMedicare ID - Type UnspecifiedPT