Provider Demographics
NPI:1265504799
Name:SAYSON, ROWENA P (PT)
Entity Type:Individual
Prefix:MS
First Name:ROWENA
Middle Name:P
Last Name:SAYSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 E BRADFORD AVE
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07009-1982
Mailing Address - Country:US
Mailing Address - Phone:201-941-2160
Mailing Address - Fax:973-857-2798
Practice Address - Street 1:117 WATERFORD TOWERS
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-2301
Practice Address - Country:US
Practice Address - Phone:201-840-5330
Practice Address - Fax:201-428-1116
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01107000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ16B11Medicare ID - Type UnspecifiedPROVIDER NUMBER