Provider Demographics
NPI:1255459632
Name:GATCHALIAN, MARIA C (PT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:C
Last Name:GATCHALIAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 RARITAN CENTER PKWY
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-3625
Mailing Address - Country:US
Mailing Address - Phone:732-225-5454
Mailing Address - Fax:
Practice Address - Street 1:135 RARITAN CENTER PKWY
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-3625
Practice Address - Country:US
Practice Address - Phone:732-225-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00493400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist