Provider Demographics
NPI:1750353991
Name:ROSS, GLORIA ESTHER (PT)
Entity type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:ESTHER
Last Name:ROSS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3803 GALLOPING HILL LN
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-1918
Mailing Address - Country:US
Mailing Address - Phone:732-961-1599
Mailing Address - Fax:
Practice Address - Street 1:3458 NEELY RD
Practice Address - Street 2:305TH MEDICAL GROUP
Practice Address - City:MCGUIRE AIR FORCE BASE
Practice Address - State:NJ
Practice Address - Zip Code:08641
Practice Address - Country:US
Practice Address - Phone:609-754-9399
Practice Address - Fax:609-754-9077
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00670400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist