Provider Demographics
NPI:1285425280
Name:DEFEIS, RILEY (DPT)
Entity type:Individual
Prefix:
First Name:RILEY
Middle Name:
Last Name:DEFEIS
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 1:2457 POLHEMUS RD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-8149
Mailing Address - Country:US
Mailing Address - Phone:732-939-5937
Mailing Address - Fax:732-939-5937
Practice Address - Street 1:2444 ROUTE 34 STE A
Practice Address - Street 2:
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1818
Practice Address - Country:US
Practice Address - Phone:732-751-4470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02331100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist