Provider Demographics
NPI:1609971936
Name:MAYER, JEANETTE Q (PT)
Entity Type:Individual
Prefix:MRS
First Name:JEANETTE
Middle Name:Q
Last Name:MAYER
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 1:27 RONARM DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07046-1422
Mailing Address - Country:US
Mailing Address - Phone:856-628-6395
Mailing Address - Fax:
Practice Address - Street 1:27 RONARM DR
Practice Address - Street 2:
Practice Address - City:MOUNTAIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07046-1422
Practice Address - Country:US
Practice Address - Phone:856-628-6395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA01067800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist