Provider Demographics
NPI:1225044209
Name:CRISPIN, JEFFREY S (PT)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:S
Last Name:CRISPIN
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 1:1023 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PITMAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08071
Mailing Address - Country:US
Mailing Address - Phone:856-256-2652
Mailing Address - Fax:
Practice Address - Street 1:8 N BROADWAY
Practice Address - Street 2:SUITE 1 HEARTLAND REHABILITATION SERVICES OF NJ INC
Practice Address - City:PITMAN
Practice Address - State:NJ
Practice Address - Zip Code:08071
Practice Address - Country:US
Practice Address - Phone:856-256-9800
Practice Address - Fax:856-218-0358
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00451900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist