Provider Demographics
NPI:1558546895
Name:LLEVA-JUMAOAS, NENETTE (PT)
Entity Type:Individual
Prefix:
First Name:NENETTE
Middle Name:
Last Name:LLEVA-JUMAOAS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:NENETTE
Other - Middle Name:
Other - Last Name:LLEVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3 GARY RD
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-4024
Mailing Address - Country:US
Mailing Address - Phone:908-918-9889
Mailing Address - Fax:
Practice Address - Street 1:1 DIAMOND HILL RD
Practice Address - Street 2:
Practice Address - City:BERKELEY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07922-2104
Practice Address - Country:US
Practice Address - Phone:908-277-8936
Practice Address - Fax:908-673-7336
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00804800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist