Provider Demographics
NPI:1841746039
Name:ESEMPLARE, NICHOLAS J (DPT)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:J
Last Name:ESEMPLARE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 S SUNSET LN
Mailing Address - Street 2:
Mailing Address - City:POMPTON PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07444-1676
Mailing Address - Country:US
Mailing Address - Phone:973-610-2755
Mailing Address - Fax:
Practice Address - Street 1:1700 NJ-23
Practice Address - Street 2:SUITE 110
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470
Practice Address - Country:US
Practice Address - Phone:973-250-8885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-29
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27416225100000X
NJ40QA01681200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist