Provider Demographics
NPI:1922035435
Name:NASH, WILLIAM JAMES (PT)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JAMES
Last Name:NASH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 ARNEYS MT RD
Mailing Address - Street 2:
Mailing Address - City:PEMBERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08068
Mailing Address - Country:US
Mailing Address - Phone:609-261-4205
Mailing Address - Fax:
Practice Address - Street 1:3001 BRIDGEBORO RD
Practice Address - Street 2:
Practice Address - City:DELRAN
Practice Address - State:NJ
Practice Address - Zip Code:08075-9700
Practice Address - Country:US
Practice Address - Phone:856-764-0494
Practice Address - Fax:856-764-0580
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00184700174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ40QA00184700OtherPT LICENCE #
NJ082113Medicare ID - Type Unspecified