Provider Demographics
NPI:1326120015
Name:STAINES, BETH MARIE (MPT)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:MARIE
Last Name:STAINES
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 W JIMMIE LEEDS RD STE 401
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9400
Mailing Address - Country:US
Mailing Address - Phone:609-748-5193
Mailing Address - Fax:609-748-5197
Practice Address - Street 1:76 W JIMMIE LEEDS RD STE 401
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9400
Practice Address - Country:US
Practice Address - Phone:609-748-5193
Practice Address - Fax:609-748-5197
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01140800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist