Provider Demographics
NPI:1356761746
Name:MCGRATH, SEAN (PT)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:MCGRATH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 TERRACE AVE
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1164
Mailing Address - Country:US
Mailing Address - Phone:732-761-0302
Mailing Address - Fax:732-761-0305
Practice Address - Street 1:300 CORPORATE CENTER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8736
Practice Address - Country:US
Practice Address - Phone:732-761-0302
Practice Address - Fax:732-761-0305
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-24
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA007824002251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics