Provider Demographics
NPI:1649810771
Name:SCHWEIGHARDT, TROY D (DPT)
Entity type:Individual
Prefix:
First Name:TROY
Middle Name:D
Last Name:SCHWEIGHARDT
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:871 MOUNTAIN AVE STE 122
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-3434
Mailing Address - Country:US
Mailing Address - Phone:973-467-0011
Mailing Address - Fax:
Practice Address - Street 1:871 MOUNTAIN AVE STE 122
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-3434
Practice Address - Country:US
Practice Address - Phone:973-467-0011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01896100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ40QA01896100OtherSTATE LICENSE