Provider Demographics
NPI:1225225303
Name:VAN DIEN, JAMES JOSEPH JR (MSPT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:JOSEPH
Last Name:VAN DIEN
Suffix:JR
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 SCHUYLER AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NORTH ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07031-5412
Mailing Address - Country:US
Mailing Address - Phone:201-991-3800
Mailing Address - Fax:201-991-4800
Practice Address - Street 1:170 SCHUYLER AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:NORTH ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07031-5412
Practice Address - Country:US
Practice Address - Phone:201-991-3800
Practice Address - Fax:201-991-4800
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01259400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist