Provider Demographics
NPI:1922774611
Name:DZEMA, DOUGLAS JR (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:
Last Name:DZEMA
Suffix:JR
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 1:50 WILLIAMS PKWY STE D
Mailing Address - Street 2:
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936-2110
Mailing Address - Country:US
Mailing Address - Phone:973-585-6008
Mailing Address - Fax:
Practice Address - Street 1:50 WILLIAMS PKWY STE D
Practice Address - Street 2:
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936-2110
Practice Address - Country:US
Practice Address - Phone:973-585-6008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-21
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist