Provider Demographics
NPI:1437553757
Name:CENTOLANZA-JACOBS, ERIN
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:CENTOLANZA-JACOBS
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 1:1 BETHANY ROAD
Mailing Address - Street 2:BLDG 4, STE 53
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730
Mailing Address - Country:US
Mailing Address - Phone:732-264-6106
Mailing Address - Fax:732-264-1117
Practice Address - Street 1:186 CENTER ST STE 100
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NJ
Practice Address - Zip Code:08809-1385
Practice Address - Country:US
Practice Address - Phone:908-323-2854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-15
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist