Provider Demographics
NPI:1316593460
Name:DEAK, JESSICA ANN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ANN
Last Name:DEAK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 CRAIG RD
Mailing Address - Street 2:STE 2
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3267
Mailing Address - Country:US
Mailing Address - Phone:732-462-2162
Mailing Address - Fax:732-462-2137
Practice Address - Street 1:120 CRAIG RD STE 2
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3267
Practice Address - Country:US
Practice Address - Phone:732-462-2162
Practice Address - Fax:732-462-2137
Is Sole Proprietor?:No
Enumeration Date:2019-08-14
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA018759002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic