Provider Demographics
NPI:1841234986
Name:EBERLE, PAUL O (MS,MP)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:O
Last Name:EBERLE
Suffix:
Gender:M
Credentials:MS,MP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 LACEY RD
Mailing Address - Street 2:STE 9-12
Mailing Address - City:WHITING
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-2947
Mailing Address - Country:US
Mailing Address - Phone:732-849-0700
Mailing Address - Fax:732-849-4718
Practice Address - Street 1:67 LACEY RD
Practice Address - Street 2:STE 9-12
Practice Address - City:WHITING
Practice Address - State:NJ
Practice Address - Zip Code:08759-2947
Practice Address - Country:US
Practice Address - Phone:732-849-0700
Practice Address - Fax:732-849-4718
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01185500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist