Provider Demographics
NPI:1851625347
Name:DANZI, EDWARD JUDE (NCMT)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:JUDE
Last Name:DANZI
Suffix:
Gender:M
Credentials:NCMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 DARTMOUTH DR
Mailing Address - Street 2:
Mailing Address - City:WENONAH
Mailing Address - State:NJ
Mailing Address - Zip Code:08090-1005
Mailing Address - Country:US
Mailing Address - Phone:856-468-6139
Mailing Address - Fax:856-582-3636
Practice Address - Street 1:207 HOLLY DELL DR
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-9184
Practice Address - Country:US
Practice Address - Phone:856-468-6139
Practice Address - Fax:856-582-3636
Is Sole Proprietor?:No
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26BT00026300225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist