Provider Demographics
NPI:1710494356
Name:ALBERT, KLEJDJA (MSC PT)
Entity Type:Individual
Prefix:MRS
First Name:KLEJDJA
Middle Name:
Last Name:ALBERT
Suffix:
Gender:F
Credentials:MSC PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 LAKE ISLE DR
Mailing Address - Street 2:
Mailing Address - City:WEST MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07480-4177
Mailing Address - Country:US
Mailing Address - Phone:201-554-5415
Mailing Address - Fax:
Practice Address - Street 1:82 TOTOWA RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-3114
Practice Address - Country:US
Practice Address - Phone:201-819-5070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-04
Last Update Date:2021-12-10
Deactivation Date:2018-08-22
Deactivation Code:
Reactivation Date:2018-10-11
Provider Licenses
StateLicense IDTaxonomies
NY042672225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist