Provider Demographics
NPI:1447396395
Name:REDLICH, JONI MICHELLE (PT, DPT, PCS)
Entity Type:Individual
Prefix:DR
First Name:JONI
Middle Name:MICHELLE
Last Name:REDLICH
Suffix:
Gender:F
Credentials:PT, DPT, PCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 W MAIN ST
Mailing Address - Street 2:STE 347
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-2218
Mailing Address - Country:US
Mailing Address - Phone:908-543-4390
Mailing Address - Fax:908-450-6126
Practice Address - Street 1:34 W MAIN ST
Practice Address - Street 2:STE 347
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2218
Practice Address - Country:US
Practice Address - Phone:908-543-4390
Practice Address - Fax:908-450-6126
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA009338002251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics