Provider Demographics
NPI:1952408296
Name:CHUA, RODOLFO JR (PT)
Entity Type:Individual
Prefix:
First Name:RODOLFO
Middle Name:
Last Name:CHUA
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:506 SPENCER DR
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-2925
Mailing Address - Country:US
Mailing Address - Phone:201-757-3899
Mailing Address - Fax:
Practice Address - Street 1:575 HIGH MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:NORTH HALEDON
Practice Address - State:NJ
Practice Address - Zip Code:07508-2662
Practice Address - Country:US
Practice Address - Phone:973-949-3657
Practice Address - Fax:973-949-3658
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA0105972251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports