Provider Demographics
NPI:1326072570
Name:BRUMMER, ERIC R (PT, CHT)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:R
Last Name:BRUMMER
Suffix:
Gender:M
Credentials:PT, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ELDEN DR
Mailing Address - Street 2:
Mailing Address - City:SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-2809
Mailing Address - Country:US
Mailing Address - Phone:201-264-2099
Mailing Address - Fax:201-265-3040
Practice Address - Street 1:1 SEARS DR
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3515
Practice Address - Country:US
Practice Address - Phone:201-265-1500
Practice Address - Fax:201-265-3040
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00661200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ104672Medicare PIN