Provider Demographics
NPI:1598165136
Name:BARKER, BRYAN ANTHONY (DPT, PT)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:ANTHONY
Last Name:BARKER
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:468 HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:KEARNY
Mailing Address - State:NJ
Mailing Address - Zip Code:07032-3610
Mailing Address - Country:US
Mailing Address - Phone:201-289-0662
Mailing Address - Fax:
Practice Address - Street 1:2 CHANGEBRIDGE RD
Practice Address - Street 2:EAST BUILDING, SUITE F
Practice Address - City:MONTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07045-8947
Practice Address - Country:US
Practice Address - Phone:973-917-3134
Practice Address - Fax:973-917-3138
Is Sole Proprietor?:No
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01567800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist