Provider Demographics
NPI:1710025945
Name:PREVITE, FRANK (MPT CERT MDT)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:PREVITE
Suffix:
Gender:M
Credentials:MPT CERT MDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 AMWELL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-1226
Mailing Address - Country:US
Mailing Address - Phone:908-725-5955
Mailing Address - Fax:908-725-9803
Practice Address - Street 1:390 AMWELL RD STE 101
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-1226
Practice Address - Country:US
Practice Address - Phone:908-725-5955
Practice Address - Fax:908-725-9803
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA004865002251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ695629Medicare PIN