Provider Demographics
NPI:1639376486
Name:OYALES, CARMEL MARIE (PT)
Entity Type:Individual
Prefix:
First Name:CARMEL
Middle Name:MARIE
Last Name:OYALES
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 1:29 ANDERSON RD
Mailing Address - Street 2:
Mailing Address - City:WHARTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07885-2038
Mailing Address - Country:US
Mailing Address - Phone:973-262-9038
Mailing Address - Fax:
Practice Address - Street 1:84 COLD HILL RD
Practice Address - Street 2:
Practice Address - City:MENDHAM
Practice Address - State:NJ
Practice Address - Zip Code:07945-2021
Practice Address - Country:US
Practice Address - Phone:973-543-3540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2010-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01065500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ069382RQAMedicare UPIN