Basic Information
Provider Information
NPI: 1104386820
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALDERFER
FirstName: JILLIAN
MiddleName: KARI
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7 CARNEGIE PLZ
Address2:  
City: CHERRY HILL
State: NJ
PostalCode: 080031000
CountryCode: US
TelephoneNumber: 8774073422
FaxNumber: 8774074329
Practice Location
Address1: 555 MARRIOTT DR STE 3153
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372145020
CountryCode: US
TelephoneNumber: 8774073422
FaxNumber: 8774074329
Other Information
ProviderEnumerationDate: 03/20/2019
LastUpdateDate: 03/20/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X11504TNY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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