Provider Demographics
NPI:1225361033
Name:RATH, MICHAEL (ATC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:RATH
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 AUGUSTA HILL RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07822-2015
Mailing Address - Country:US
Mailing Address - Phone:973-948-6680
Mailing Address - Fax:
Practice Address - Street 1:11 AUGUSTA HILL RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:NJ
Practice Address - Zip Code:07822-2015
Practice Address - Country:US
Practice Address - Phone:973-948-6680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-10
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0045932255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer