Provider Demographics
NPI:1740594670
Name:FILARDI, AUDREY S (NCTMB)
Entity type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:S
Last Name:FILARDI
Suffix:
Gender:F
Credentials:NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2570 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-4103
Mailing Address - Country:US
Mailing Address - Phone:609-839-3810
Mailing Address - Fax:
Practice Address - Street 1:415 ROUTE 9
Practice Address - Street 2:SUITE # 3
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2106
Practice Address - Country:US
Practice Address - Phone:609-593-3190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-03
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ520133-06225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist