Provider Demographics
NPI:1467241430
Name:CARMODY, DALE
Entity type:Individual
Prefix:
First Name:DALE
Middle Name:
Last Name:CARMODY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 W PARK PL STE 7
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-4562
Mailing Address - Country:US
Mailing Address - Phone:973-939-3999
Mailing Address - Fax:
Practice Address - Street 1:40 W PARK PL STE 7
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-4562
Practice Address - Country:US
Practice Address - Phone:973-939-3999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KB00045700225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist