Provider Demographics
NPI:1982654208
Name:HEIM, PAUL (PT)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:HEIM
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1377 MOTOR PKWY
Mailing Address - Street 2:STE 307
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-5258
Mailing Address - Country:US
Mailing Address - Phone:856-690-9977
Mailing Address - Fax:856-507-9918
Practice Address - Street 1:1940 S WEST BLVD
Practice Address - Street 2:BLDG A
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-7024
Practice Address - Country:US
Practice Address - Phone:856-690-9977
Practice Address - Fax:856-507-9918
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ40QA00404100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist