Provider Demographics
NPI:1760706410
Name:MACKENZIE, NIKKA PAULA (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:NIKKA
Middle Name:PAULA
Last Name:MACKENZIE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:NIKKA
Other - Middle Name:PAULA
Other - Last Name:ALCORIZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:401 LACEY RD STE A
Mailing Address - Street 2:
Mailing Address - City:WHITING
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-1386
Mailing Address - Country:US
Mailing Address - Phone:732-350-2355
Mailing Address - Fax:732-350-1905
Practice Address - Street 1:401 LACEY RD STE A
Practice Address - Street 2:
Practice Address - City:WHITING
Practice Address - State:NJ
Practice Address - Zip Code:08759-1386
Practice Address - Country:US
Practice Address - Phone:732-350-2355
Practice Address - Fax:732-350-1905
Is Sole Proprietor?:No
Enumeration Date:2010-03-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01337700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist