Provider Demographics
NPI:1841622362
Name:JALANDO-ON, NORPHINE ANTONANO
Entity type:Individual
Prefix:MISS
First Name:NORPHINE
Middle Name:ANTONANO
Last Name:JALANDO-ON
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 1:926 BLOOMFIELD AVE
Mailing Address - Street 2:1K
Mailing Address - City:GLEN RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07028-1330
Mailing Address - Country:US
Mailing Address - Phone:561-303-7357
Mailing Address - Fax:
Practice Address - Street 1:926 BLOOMFIELD AVE
Practice Address - Street 2:1K
Practice Address - City:GLEN RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07028-1330
Practice Address - Country:US
Practice Address - Phone:561-303-7357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-07
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0389552251P0200X, 2251G0304X, 2251X0800X
IL160006409225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic