Mr. Russell K Ditchfield-Agboh, PT
Physical Therapist in Montclair, New Jersey
1487905444- Practice location
- 141 Walnut St Apt 2, Montclair, NJ 07042-3885
- Phone
- 201-888-0444
- Fax
- —
- Last updated
- September 30, 2012
Russell K. Ditchfield-Agboh is a Physical Therapist based in Montclair, NJ. Russell K. Ditchfield-Agboh practices in Montclair, NJ and has the professional credentials of PT. The NPI Number for Russell K. Ditchfield-Agboh is 1487905444 and holds a License No. 40QA00938000 (NJ). The current practice location address for Russell K. Ditchfield-Agboh is 141 Walnut St Apt 2, Montclair, NJ 07042-3885 and can be reached out via phone at 201-888-0444.
Provider Profile Details
- NPI Number
- 1487905444
- Provider Name
- Russell K. Ditchfield-Agboh
- Credential
- PT
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 141 Walnut St Apt 2, Montclair, NJ 07042-3885
- Phone Number
- 201-888-0444
- Primary Taxonomy
- Physical Therapist · 225100000X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- September 30, 2012
- Last Update Date
- September 30, 2012
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 141 Walnut St Apt 2
Montclair, NJ 07042-3885 - City
- Montclair
- State
- New Jersey
- Zip
- 07042-3885
- Phone Number
- 201-888-0444
Provider Business Mailing Address Details
- Address
- 141 Walnut St Apt 2
Montclair, NJ 07042-3885 - City
- Montclair
- State
- NJ
- Zip
- 07042-3885
- Phone Number
- 201-888-0444
License Information
- License Number
- 40QA00938000
- License State
- NJ
- Taxonomy
- Physical Therapist · 225100000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Mr. Russell K Ditchfield-Agboh, PT?
The NPI number of Mr. Russell K Ditchfield-Agboh, PT is 1487905444. It was assigned on September 30, 2012 and is currently active in the NPPES registry.
What is the specialty of Mr. Russell K Ditchfield-Agboh, PT?
Mr. Russell K Ditchfield-Agboh, PT is registered under the primary taxonomy Physical Therapist (code 225100000X), licensed in NJ under license number 40QA00938000.
Where does Mr. Russell K Ditchfield-Agboh, PT practice?
The practice location is 141 Walnut St Apt 2, Montclair, NJ 07042-3885. The office can be reached at 201-888-0444 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1487905444 directly on the NPPES registry website.