Provider Demographics
NPI:1740216142
Name:SANGLAY, EDMUNDO REY JR (PT)
Entity Type:Individual
Prefix:
First Name:EDMUNDO
Middle Name:REY
Last Name:SANGLAY
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 DEGRAW AVE
Mailing Address - Street 2:NJOS
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666
Mailing Address - Country:US
Mailing Address - Phone:201-692-9699
Mailing Address - Fax:201-530-0085
Practice Address - Street 1:106 GRAND AVE
Practice Address - Street 2:NORTH JERSEY ORTHOPEDIC SPECIALISTS
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631
Practice Address - Country:US
Practice Address - Phone:201-608-0109
Practice Address - Fax:201-608-0110
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA011106002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
090394BMPMedicare ID - Type Unspecified