Provider Demographics
NPI:1982710026
Name:FACTOR, ANNALISSA CABRERA (PT)
Entity Type:Individual
Prefix:
First Name:ANNALISSA
Middle Name:CABRERA
Last Name:FACTOR
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 1:902 CHELSEA RD
Mailing Address - Street 2:
Mailing Address - City:ABSECON
Mailing Address - State:NJ
Mailing Address - Zip Code:08201-1653
Mailing Address - Country:US
Mailing Address - Phone:917-378-3541
Mailing Address - Fax:609-855-5030
Practice Address - Street 1:2300 NEW RD STE 100B
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1457
Practice Address - Country:US
Practice Address - Phone:609-377-7845
Practice Address - Fax:609-855-5030
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11095225100000X
NY016879-1225100000X
NJ40QA01049200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist