Provider Demographics
NPI:1669451076
Name:CARPENTER, LOIS A (PT)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:A
Last Name:CARPENTER
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 1:98 W 9TH ST
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-1302
Mailing Address - Country:US
Mailing Address - Phone:908-766-1407
Mailing Address - Fax:908-953-8454
Practice Address - Street 1:150 N FINLEY AVE
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-1686
Practice Address - Country:US
Practice Address - Phone:908-766-1407
Practice Address - Fax:908-953-8454
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00373600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ027511NEPMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER