Provider Demographics
NPI:1891841466
Name:MAGRONE, LOUIS C (PT, DPT)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:C
Last Name:MAGRONE
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3499 ROUTE 9 N
Mailing Address - Street 2:SUITE 3 B
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-3258
Mailing Address - Country:US
Mailing Address - Phone:732-409-9985
Mailing Address - Fax:732-409-9986
Practice Address - Street 1:3499 ROUTE 9 N
Practice Address - Street 2:SUITE 3 B
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-3258
Practice Address - Country:US
Practice Address - Phone:732-409-9985
Practice Address - Fax:732-409-9986
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY62-02889225100000X
NJ40QA01236200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ114475BC1Medicare PIN