Provider Demographics
NPI:1134436611
Name:TORCIVIA, PETER CHARLES (DPT)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:CHARLES
Last Name:TORCIVIA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1465 STATE HWY 31
Mailing Address - Street 2:THIRD FLOOR
Mailing Address - City:ANNANDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08801
Mailing Address - Country:US
Mailing Address - Phone:908-328-3300
Mailing Address - Fax:908-328-3268
Practice Address - Street 1:1465 STATE HWY 31
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:ANNANDALE
Practice Address - State:NJ
Practice Address - Zip Code:08801
Practice Address - Country:US
Practice Address - Phone:908-328-3300
Practice Address - Fax:908-328-3268
Is Sole Proprietor?:No
Enumeration Date:2010-09-07
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01358900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist