Provider Demographics
NPI:1750390324
Name:CARRERO, MONICA L (DPT)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:L
Last Name:CARRERO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 VALLEY RD STE 2002ND
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2073
Mailing Address - Country:US
Mailing Address - Phone:201-485-3340
Mailing Address - Fax:
Practice Address - Street 1:1401 VALLEY RD STE 2002ND
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2073
Practice Address - Country:US
Practice Address - Phone:201-485-3340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01134400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2481470OtherUHC PROVIDER NUMBER
NJ3708343OtherAETNA PROVIDER NUMBER
NJ6697131OtherGHI PROVIDER NUMBER
NJ9362671OtherPHCS PROVIDER NUMBER
NJP00409301OtherRAILROAD MEDICARE
NJP00409301OtherRAILROAD MEDICARE