Provider Demographics
NPI:1437230182
Name:BURNS, ROSE MARIE (PT)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:MARIE
Last Name:BURNS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:MARIE
Other - Last Name:GALLAGHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1430 HOOPER AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2895
Mailing Address - Country:US
Mailing Address - Phone:732-255-7888
Mailing Address - Fax:732-855-9755
Practice Address - Street 1:1430 HOOPER AVE STE 201
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2895
Practice Address - Country:US
Practice Address - Phone:732-255-7888
Practice Address - Fax:732-855-9755
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00354500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00627288OtherRAIL ROAD MEDICARE
NJ108475Medicare PIN