Provider Demographics
NPI:1245459296
Name:CUBBERLEY, DAVID HARRY (MSPT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:HARRY
Last Name:CUBBERLEY
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:558 BUTTONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-4906
Mailing Address - Country:US
Mailing Address - Phone:732-928-1438
Mailing Address - Fax:
Practice Address - Street 1:255 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-2982
Practice Address - Country:US
Practice Address - Phone:856-813-5822
Practice Address - Fax:856-235-2080
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00563500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist