Provider Demographics
NPI:1982151221
Name:PERNIOLA, ROBERT (DPT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:PERNIOLA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 COUNTY ROAD 520 STE 1
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1246
Mailing Address - Country:US
Mailing Address - Phone:732-972-6010
Mailing Address - Fax:732-972-3862
Practice Address - Street 1:186 COUNTY ROAD 520 STE 1
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-1246
Practice Address - Country:US
Practice Address - Phone:732-972-6010
Practice Address - Fax:732-972-3862
Is Sole Proprietor?:No
Enumeration Date:2016-09-03
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01687700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist