Provider Demographics
NPI:1316035165
Name:FLASHBURG, ELLEN BETH (PT, OT)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:BETH
Last Name:FLASHBURG
Suffix:
Gender:F
Credentials:PT, OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 CAMBRIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-3231
Mailing Address - Country:US
Mailing Address - Phone:732-918-0864
Mailing Address - Fax:732-918-1808
Practice Address - Street 1:15 CAMBRIDGE WAY
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-3231
Practice Address - Country:US
Practice Address - Phone:732-918-0864
Practice Address - Fax:732-918-1808
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00280000225100000X
NJ46TR00377600225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist