Provider Demographics
NPI:1245395235
Name:COLMENARES, HUMBERTO (PT)
Entity Type:Individual
Prefix:MR
First Name:HUMBERTO
Middle Name:
Last Name:COLMENARES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:701 NEWARK AVE STE 212
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-3560
Mailing Address - Country:US
Mailing Address - Phone:908-527-6001
Mailing Address - Fax:908-527-6634
Practice Address - Street 1:75 MONTGOMERY ST FL 501
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-3726
Practice Address - Country:US
Practice Address - Phone:201-433-6001
Practice Address - Fax:201-433-6634
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA004896002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic