Provider Demographics
NPI:1831311414
Name:SELLNOW, JAMES SANFORD (MPT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:SANFORD
Last Name:SELLNOW
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1195 ROUTE 70
Mailing Address - Street 2:UNIT 1001
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5946
Mailing Address - Country:US
Mailing Address - Phone:732-905-7818
Mailing Address - Fax:732-905-7754
Practice Address - Street 1:9 MULE RD
Practice Address - Street 2:SUITE E-2
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5043
Practice Address - Country:US
Practice Address - Phone:732-473-1666
Practice Address - Fax:732-473-1601
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00870300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ094914Medicare PIN