Provider Demographics
NPI:1689660086
Name:AMALFITANO, PAUL GUY (DPT, ATC)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:GUY
Last Name:AMALFITANO
Suffix:
Gender:M
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4250 HARBOR BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:BRIGANTINE
Mailing Address - State:NJ
Mailing Address - Zip Code:08203-1361
Mailing Address - Country:US
Mailing Address - Phone:609-264-8800
Mailing Address - Fax:609-264-0097
Practice Address - Street 1:4250 HARBOR BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BRIGANTINE
Practice Address - State:NJ
Practice Address - Zip Code:08203-1361
Practice Address - Country:US
Practice Address - Phone:609-264-8800
Practice Address - Fax:609-264-0097
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2020-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01181800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist