Provider Demographics
NPI:1851500367
Name:LIMLINGAN, VICSON TONGOL (BSPT)
Entity Type:Individual
Prefix:
First Name:VICSON
Middle Name:TONGOL
Last Name:LIMLINGAN
Suffix:
Gender:M
Credentials:BSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:461 ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07646-1014
Mailing Address - Country:US
Mailing Address - Phone:201-726-2211
Mailing Address - Fax:201-244-6974
Practice Address - Street 1:800 RIVER RD
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07646-3127
Practice Address - Country:US
Practice Address - Phone:201-967-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00978800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist