Provider Demographics
NPI:1851789168
Name:TARGET THERAPEUTICS CORPORATION
Entity Type:Organization
Organization Name:TARGET THERAPEUTICS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:VARIPAPA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:347-203-0939
Mailing Address - Street 1:761 PALMER AVE
Mailing Address - Street 2:1
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1086
Mailing Address - Country:US
Mailing Address - Phone:732-769-2536
Mailing Address - Fax:
Practice Address - Street 1:23 STONEY BROOK RD
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1111
Practice Address - Country:US
Practice Address - Phone:732-203-1929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00673100261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy