Provider Demographics
NPI:1417227836
Name:NOTO, CHARLENE (PTA)
Entity Type:Individual
Prefix:
First Name:CHARLENE
Middle Name:
Last Name:NOTO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1 BETHANY RD BLDG 4
Mailing Address - Street 2:SUITE 53, BETHANY COMMONS
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1667
Mailing Address - Country:US
Mailing Address - Phone:732-335-8111
Mailing Address - Fax:732-335-8118
Practice Address - Street 1:1 BETHANY RD BLDG 4
Practice Address - Street 2:SUITE 53, BETHANY COMMONS
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1667
Practice Address - Country:US
Practice Address - Phone:732-335-8111
Practice Address - Fax:732-335-8118
Is Sole Proprietor?:No
Enumeration Date:2012-01-02
Last Update Date:2012-01-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ40QA00720800225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant