Provider Demographics
NPI:1629533039
Name:DEAREY THERAPY SERVICES LLC
Entity Type:Organization
Organization Name:DEAREY THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:DEAREY
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:908-963-3976
Mailing Address - Street 1:PO BOX 4501
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-0501
Mailing Address - Country:US
Mailing Address - Phone:908-963-3976
Mailing Address - Fax:
Practice Address - Street 1:76 STIRLING RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5778
Practice Address - Country:US
Practice Address - Phone:908-963-3976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-10
Last Update Date:2019-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1477897601OtherSPECIALIST