Provider Demographics
NPI:1184996878
Name:DIBENEDETTO, ANNE-MARIE (MPT,DPT)
Entity type:Individual
Prefix:
First Name:ANNE-MARIE
Middle Name:
Last Name:DIBENEDETTO
Suffix:
Gender:F
Credentials:MPT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 NORTH MAPLE AVE SUTIE B-10
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053
Mailing Address - Country:US
Mailing Address - Phone:856-396-2500
Mailing Address - Fax:856-396-2525
Practice Address - Street 1:230 N MAPLE AVE STE B10
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-9423
Practice Address - Country:US
Practice Address - Phone:856-396-2500
Practice Address - Fax:856-396-2525
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-27
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1659319002OtherADDING LOCATION