Provider Demographics
NPI:1710230578
Name:MAURER, JOHN W (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:W
Last Name:MAURER
Suffix:
Gender:M
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 1:516 PLYMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-4581
Mailing Address - Country:US
Mailing Address - Phone:856-332-1353
Mailing Address - Fax:
Practice Address - Street 1:516 PLYMOUTH RD
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902
Practice Address - Country:US
Practice Address - Phone:856-332-1353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01413000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist