Provider Demographics
NPI:1467724880
Name:PENNETTI, ADELINA LINDA (DPT)
Entity Type:Individual
Prefix:
First Name:ADELINA
Middle Name:LINDA
Last Name:PENNETTI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:788 MORRIS TPKE STE 301
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-2634
Mailing Address - Country:US
Mailing Address - Phone:973-467-4444
Mailing Address - Fax:
Practice Address - Street 1:788 MORRIS TPKE STE 301
Practice Address - Street 2:
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07078-2634
Practice Address - Country:US
Practice Address - Phone:973-467-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00693700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist