Provider Demographics
NPI:1932415189
Name:MCEWING, LORI ELLEN (PTA)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:ELLEN
Last Name:MCEWING
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 TOWN BANK RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CAPE MAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08204-4411
Mailing Address - Country:US
Mailing Address - Phone:609-898-8899
Mailing Address - Fax:
Practice Address - Street 1:700 TOWN BANK RD
Practice Address - Street 2:
Practice Address - City:NORTH CAPE MAY
Practice Address - State:NJ
Practice Address - Zip Code:08204-4411
Practice Address - Country:US
Practice Address - Phone:609-898-8899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00030700225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant