Provider Demographics
NPI:1740410562
Name:SPOLTORE, TIFFANY N (DPT)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:N
Last Name:SPOLTORE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:N
Other - Last Name:WEAVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:210 S SHORE RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MARMORA
Mailing Address - State:NJ
Mailing Address - Zip Code:08223-1200
Mailing Address - Country:US
Mailing Address - Phone:609-390-2400
Mailing Address - Fax:609-390-9587
Practice Address - Street 1:210 S SHORE RD
Practice Address - Street 2:SUITE 203
Practice Address - City:MARMORA
Practice Address - State:NJ
Practice Address - Zip Code:08223-1200
Practice Address - Country:US
Practice Address - Phone:609-390-2400
Practice Address - Fax:609-390-9587
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01318000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist