Provider Demographics
NPI:1356568240
Name:WHITE, MONICA FREITAS (PT, MS)
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:FREITAS
Last Name:WHITE
Suffix:
Gender:F
Credentials:PT, MS
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:FRANCES
Other - Last Name:FREITAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT,MS
Mailing Address - Street 1:71 BLOSSOM RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08827-2710
Mailing Address - Country:US
Mailing Address - Phone:908-537-9695
Mailing Address - Fax:
Practice Address - Street 1:401 COVENTRY DR
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1969
Practice Address - Country:US
Practice Address - Phone:908-859-8342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA00468900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist