Provider Demographics
NPI:1346651395
Name:SHARPE, JASON (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:SHARPE
Suffix:
Gender:M
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 1:190 KIHADE TRL
Mailing Address - Street 2:
Mailing Address - City:MEDFORD LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-1718
Mailing Address - Country:US
Mailing Address - Phone:609-828-3352
Mailing Address - Fax:
Practice Address - Street 1:2241 TREELIGHT WAY STE 104
Practice Address - Street 2:
Practice Address - City:WENDELL
Practice Address - State:NC
Practice Address - Zip Code:27591-3212
Practice Address - Country:US
Practice Address - Phone:919-241-8996
Practice Address - Fax:919-820-8497
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP19891225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist