Provider Demographics
NPI:1508825654
Name:MCBRIDE, ANNETTE M (PTA)
Entity Type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:M
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 ARENA DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610
Mailing Address - Country:US
Mailing Address - Phone:609-585-2333
Mailing Address - Fax:609-585-6522
Practice Address - Street 1:1900 ARENA DR
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08610
Practice Address - Country:US
Practice Address - Phone:609-585-2333
Practice Address - Fax:609-585-6522
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQB00085900225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant