Provider Demographics
NPI:1235196247
Name:HOLT, SHERRI SUSAN (PT, MTC)
Entity Type:Individual
Prefix:MRS
First Name:SHERRI
Middle Name:SUSAN
Last Name:HOLT
Suffix:
Gender:F
Credentials:PT, MTC
Other - Prefix:
Other - First Name:SHERRI
Other - Middle Name:SUSAN
Other - Last Name:HEWITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:349 MAIN AVENUE
Mailing Address - Street 2:#2
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07980
Mailing Address - Country:US
Mailing Address - Phone:908-766-1407
Mailing Address - Fax:908-953-8454
Practice Address - Street 1:150 N FINLEY AVE
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-1686
Practice Address - Country:US
Practice Address - Phone:908-766-1407
Practice Address - Fax:908-953-8454
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00959200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ052807NEPMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER