Provider Demographics
NPI:1619457587
Name:THREM, SHEENA M (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SHEENA
Middle Name:M
Last Name:THREM
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:WALLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07057-1113
Mailing Address - Country:US
Mailing Address - Phone:201-336-4535
Mailing Address - Fax:
Practice Address - Street 1:205 ROBIN RD STE 118
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1424
Practice Address - Country:US
Practice Address - Phone:201-225-1511
Practice Address - Fax:201-225-9731
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01808500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist