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Contact Information

BRENDAN R BOLDUC, PT, DPT, CSCS
15 S KINDERKAMACK RD
MONTVALE, NJ07645-2112
 Phone: 201-573-4969
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for BRENDAN R BOLDUC · (Male)

NPI Number 1811664899
Status Active
Credentials PT, DPT, CSCS
Entity Individual
Enumeration date 08/26/2021
Last updated 08/26/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • NJ License # 40QA02024200
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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