Provider Demographics
NPI:1780657163
Name:DELANEY, JANE (PT)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:
Last Name:DELANEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 BOWSPRIT PT
Mailing Address - Street 2:
Mailing Address - City:LANOKA HARBOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08734-2706
Mailing Address - Country:US
Mailing Address - Phone:609-971-3734
Mailing Address - Fax:
Practice Address - Street 1:137 ATLANTIC CITY BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:BEACHWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08722-2935
Practice Address - Country:US
Practice Address - Phone:732-244-8666
Practice Address - Fax:732-244-0450
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00497000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ066741Medicare ID - Type Unspecified