Provider Demographics
NPI:1922216712
Name:LOCASCIO, EISHA
Entity Type:Individual
Prefix:
First Name:EISHA
Middle Name:
Last Name:LOCASCIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EISHA
Other - Middle Name:
Other - Last Name:HUSAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:385 CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-1934
Mailing Address - Country:US
Mailing Address - Phone:201-848-4599
Mailing Address - Fax:201-848-6336
Practice Address - Street 1:385 CLINTON AVE
Practice Address - Street 2:
Practice Address - City:WYCKOFF
Practice Address - State:NJ
Practice Address - Zip Code:07481-1934
Practice Address - Country:US
Practice Address - Phone:201-848-4599
Practice Address - Fax:201-848-6336
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00627500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist