Provider Demographics
NPI:1770861882
Name:DAALDER, ROSEMARIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:
Last Name:DAALDER
Suffix:
Gender:F
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 1:67 LACEY RD
Mailing Address - Street 2:SUITES 8-12
Mailing Address - City:WHITING
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-2912
Mailing Address - Country:US
Mailing Address - Phone:732-849-9600
Mailing Address - Fax:
Practice Address - Street 1:11 EAGLE ROCK AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936-3167
Practice Address - Country:US
Practice Address - Phone:973-887-9000
Practice Address - Fax:973-887-3816
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01405100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist