Provider Demographics
NPI:1255679106
Name:HARDUBY, ANNETTE C (MS)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:C
Last Name:HARDUBY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 DEER TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:MILLSTONE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08510-1509
Mailing Address - Country:US
Mailing Address - Phone:732-977-2236
Mailing Address - Fax:
Practice Address - Street 1:125 ANDOVER RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-1222
Practice Address - Country:US
Practice Address - Phone:732-299-7530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA007866002251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics