Provider Demographics
NPI:1780732537
Name:PAULE, DENNISE (DPT)
Entity type:Individual
Prefix:
First Name:DENNISE
Middle Name:
Last Name:PAULE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:DENNISE
Other - Middle Name:
Other - Last Name:PAULE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:3 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5037
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5037
Practice Address - Country:US
Practice Address - Phone:732-432-0733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00560600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ316662Medicare ID - Type Unspecified