Provider Demographics
NPI:1881884302
Name:EMATA-PAGCU, FLORAINE (PT)
Entity type:Individual
Prefix:
First Name:FLORAINE
Middle Name:
Last Name:EMATA-PAGCU
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07014-1720
Mailing Address - Country:US
Mailing Address - Phone:973-782-3954
Mailing Address - Fax:
Practice Address - Street 1:1 MAIN ST STE 505
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-3903
Practice Address - Country:US
Practice Address - Phone:732-493-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01079100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist