Provider Demographics
NPI:1841559168
Name:RHOADES, LAUREN (PT)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:
Last Name:RHOADES
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 1:418 ROUTE 515
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:NJ
Mailing Address - Zip Code:07462-3027
Mailing Address - Country:US
Mailing Address - Phone:973-764-6136
Mailing Address - Fax:973-764-4515
Practice Address - Street 1:418 ROUTE 515
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:NJ
Practice Address - Zip Code:07462-3027
Practice Address - Country:US
Practice Address - Phone:973-764-6136
Practice Address - Fax:973-764-4515
Is Sole Proprietor?:No
Enumeration Date:2012-05-07
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01369900225100000X
NY033246-1225100000X
NJ25MT001082002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer