Provider Demographics
NPI:1336686864
Name:DUFFY, JUSTINE MARIE
Entity Type:Individual
Prefix:
First Name:JUSTINE
Middle Name:MARIE
Last Name:DUFFY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 ARENA DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610-2426
Mailing Address - Country:US
Mailing Address - Phone:609-585-2333
Mailing Address - Fax:609-585-6522
Practice Address - Street 1:1900 ARENA DR
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08610-2426
Practice Address - Country:US
Practice Address - Phone:609-585-2333
Practice Address - Fax:609-585-6522
Is Sole Proprietor?:No
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01701600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist