Provider Demographics
NPI:1720652464
Name:FONTANA, ANTHONY J (DPT)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:J
Last Name:FONTANA
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 1:321 JOHN OCHS DR
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663-5035
Mailing Address - Country:US
Mailing Address - Phone:201-264-7996
Mailing Address - Fax:
Practice Address - Street 1:321 JOHN OCHS DR
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-5035
Practice Address - Country:US
Practice Address - Phone:201-264-7996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA019171002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic