Provider Demographics
NPI:1639453269
Name:HEAD, MARGARET
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:HEAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 BRIDGE ST
Mailing Address - Street 2:BUILDING G
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2294
Mailing Address - Country:US
Mailing Address - Phone:908-403-2807
Mailing Address - Fax:
Practice Address - Street 1:254 BRIDGE ST
Practice Address - Street 2:BUILDING G
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2294
Practice Address - Country:US
Practice Address - Phone:908-403-2807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-30
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26772225100000X
NJQAO1408200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist