Provider Demographics
NPI:1801929815
Name:VOLK, JANICE L
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:L
Last Name:VOLK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 DEVON CT
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3138
Mailing Address - Country:US
Mailing Address - Phone:732-460-1277
Mailing Address - Fax:732-460-1272
Practice Address - Street 1:25 DEVON CT
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07724-3138
Practice Address - Country:US
Practice Address - Phone:732-460-1277
Practice Address - Fax:732-460-1272
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00242400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ417091Medicare ID - Type Unspecified