Provider Demographics
NPI:1467489013
Name:O'ROURKE, JAMES I
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:O'ROURKE
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:563 PARK ST
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-2027
Mailing Address - Country:US
Mailing Address - Phone:973-455-0254
Mailing Address - Fax:973-455-0256
Practice Address - Street 1:100 THE AMERICAN RD
Practice Address - Street 2:SUITE 114
Practice Address - City:MORRIS PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07950-2443
Practice Address - Country:US
Practice Address - Phone:973-455-0254
Practice Address - Fax:973-455-0256
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA009805225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist