Ivy, Anthony Frederick

Ivy, Anthony Frederick is an individual health care provider with primary practice located at 61 W Jimmie Leeds Rd , Pomona NJ 08240-9102. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Geriatrics, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic is his primary health care specialty. Ivy, Anthony Frederick can be contacted via phone (609) 652-7000.

Contact Information

Primary practice address
61 W Jimmie Leeds Rd Pomona NJ 08240-9102
Phone: (609) 652-7000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Geriatrics 2251G0304X 40QA00450600 New Jersey
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic 2251X0800X 40QA00450600 New Jersey

Profile Details

NPI number 1720785603
LBN Legal business name Ivy, Anthony Frederick
Credentials PHYSICAL THERAPIST
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2023
Last updated Feb 13th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720785603 NPPES
New Jersey MEDICAID 40QA00450600

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