Provider Demographics
NPI:1376140327
Name:NEVOLA, EMILY ANNE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANNE
Last Name:NEVOLA
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 1:49 MOUNT PLEASANT PKWY
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-2844
Mailing Address - Country:US
Mailing Address - Phone:862-485-3496
Mailing Address - Fax:
Practice Address - Street 1:49 MOUNT PLEASANT PKWY
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-2844
Practice Address - Country:US
Practice Address - Phone:862-485-3496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01945300208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation