Provider Demographics
NPI:1689399388
Name:DWIGHT DICKMAN, PAIGE ELIZABETH (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:PAIGE
Middle Name:ELIZABETH
Last Name:DWIGHT DICKMAN
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 1:1700 RACHEL TER APT 19
Mailing Address - Street 2:
Mailing Address - City:PINE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07058-9305
Mailing Address - Country:US
Mailing Address - Phone:732-895-3852
Mailing Address - Fax:
Practice Address - Street 1:43 US HIGHWAY 46 STE 706
Practice Address - Street 2:
Practice Address - City:PINE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07058-9185
Practice Address - Country:US
Practice Address - Phone:973-556-8465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-05
Last Update Date:2023-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02117100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist