Provider Demographics
NPI:1538305180
Name:MERO-SHEA, ANNA KAISA T (PT)
Entity Type:Individual
Prefix:
First Name:ANNA KAISA
Middle Name:T
Last Name:MERO-SHEA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2441 STATE ROUTE 33 STE A
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-3763
Mailing Address - Country:US
Mailing Address - Phone:732-776-4251
Mailing Address - Fax:732-776-4210
Practice Address - Street 1:2441 STATE ROUTE 33
Practice Address - Street 2:STE A
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-3763
Practice Address - Country:US
Practice Address - Phone:732-776-4251
Practice Address - Fax:732-776-4210
Is Sole Proprietor?:No
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPTQA006924002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic