Provider Demographics
NPI:1205937679
Name:RECTOR, JOHN D JR (DPT)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:D
Last Name:RECTOR
Suffix:JR
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 1:6600 KENNEDY BLVD E APT 20M
Mailing Address - Street 2:
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-4229
Mailing Address - Country:US
Mailing Address - Phone:516-818-9820
Mailing Address - Fax:
Practice Address - Street 1:6600 KENNEDY BLVD E APT 20M
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-4229
Practice Address - Country:US
Practice Address - Phone:516-818-9820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017657225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist