Basic Information
Provider Information
NPI: 1336260736
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALO
FirstName: RONAN
MiddleName: CLARDI CABARON
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 508 10TH AVE
Address2:  
City: BELMAR
State: NJ
PostalCode: 077192317
CountryCode: US
TelephoneNumber: 7329109196
FaxNumber:  
Practice Location
Address1: 7 CARNEGIE PLZ
Address2:  
City: CHERRY HILL
State: NJ
PostalCode: 080031000
CountryCode: US
TelephoneNumber: 8774073422
FaxNumber: 8774074329
Other Information
ProviderEnumerationDate: 04/03/2007
LastUpdateDate: 12/17/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X40QA01030700NJY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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