Basic Information
Provider Information
NPI: 1619316544
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STRAGER
FirstName: DANA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11 EAGLE ROCK AVE
Address2:  
City: EAST HANOVER
State: NJ
PostalCode: 07936
CountryCode: US
TelephoneNumber: 9738879000
FaxNumber: 9738873816
Practice Location
Address1: 237 FRANKLIN AVE
Address2:  
City: NUTLEY
State: NJ
PostalCode: 07110
CountryCode: US
TelephoneNumber: 9735620080
FaxNumber: 9735620081
Other Information
ProviderEnumerationDate: 06/25/2013
LastUpdateDate: 06/25/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X40QA01375600NJY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X032955NYN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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