Provider Demographics
NPI:1891071494
Name:SPEISER, EVELYN M (PT)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:M
Last Name:SPEISER
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 1:506 S NEW YORK RD
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9761
Mailing Address - Country:US
Mailing Address - Phone:609-748-0222
Mailing Address - Fax:609-748-0270
Practice Address - Street 1:506 S NEW YORK RD
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9761
Practice Address - Country:US
Practice Address - Phone:609-748-0222
Practice Address - Fax:609-748-0270
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0306432251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic