Provider Demographics
NPI:1578510020
Name:INGLETT, BARRY G (PT)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:G
Last Name:INGLETT
Suffix:
Gender:M
Credentials:PT
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Other - Last Name:
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Mailing Address - Street 1:223 WANAQUE AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:POMPTON LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07442-2103
Mailing Address - Country:US
Mailing Address - Phone:973-839-6801
Mailing Address - Fax:973-839-7293
Practice Address - Street 1:223 WANAQUE AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:POMPTON LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07442-2103
Practice Address - Country:US
Practice Address - Phone:973-839-6801
Practice Address - Fax:973-839-7293
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2010-01-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJQA01462225100000X, 2251H1200X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ515893BBWMedicare PIN