Provider Demographics
NPI:1356887517
Name:NESSER, HAIM D (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:HAIM
Middle Name:D
Last Name:NESSER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 W PARK AVE UNIT 1059
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-8042
Mailing Address - Country:US
Mailing Address - Phone:732-443-0045
Mailing Address - Fax:732-305-2005
Practice Address - Street 1:251 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-4620
Practice Address - Country:US
Practice Address - Phone:732-443-0045
Practice Address - Fax:732-305-2005
Is Sole Proprietor?:No
Enumeration Date:2017-01-12
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01707800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ40QA01707800OtherPHYSICAL THERAPY LICENSE