Provider Demographics
NPI:1649603515
Name:VITEBSKY, ZARINA S (MPT)
Entity type:Individual
Prefix:MRS
First Name:ZARINA
Middle Name:S
Last Name:VITEBSKY
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 MARTINSVILLE RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-4700
Mailing Address - Country:US
Mailing Address - Phone:908-758-1006
Mailing Address - Fax:908-360-0511
Practice Address - Street 1:665 MARTINSVILLE RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-4700
Practice Address - Country:US
Practice Address - Phone:908-758-1006
Practice Address - Fax:908-360-0511
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00996600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1750681201Medicare PIN