Provider Demographics
NPI:1558467860
Name:SEMBRANO, WAYNE G (LPT)
Entity Type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:G
Last Name:SEMBRANO
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 EAGLE ROCK AVE
Mailing Address - Street 2:FL 2
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936-3167
Mailing Address - Country:US
Mailing Address - Phone:908-474-9444
Mailing Address - Fax:908-474-8561
Practice Address - Street 1:10 N WOOD AVE
Practice Address - Street 2:SUITE E
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-5200
Practice Address - Country:US
Practice Address - Phone:908-474-9444
Practice Address - Fax:908-474-8561
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01132800174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ40QA01132800OtherPHYSICAL THERAPIST LICENS