Provider Demographics
NPI:1548398613
Name:MAULLON, CHERRY ORUGA (PT)
Entity Type:Individual
Prefix:MRS
First Name:CHERRY
Middle Name:ORUGA
Last Name:MAULLON
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 1:17 MORYAN RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-4132
Mailing Address - Country:US
Mailing Address - Phone:732-650-1225
Mailing Address - Fax:
Practice Address - Street 1:17 MORYAN RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-4132
Practice Address - Country:US
Practice Address - Phone:732-650-1225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00663800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist