Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Douglas Wallace

Individual provider Physical Therapist · NPI 1356921118

Douglas Wallace is a Physical Therapist in Weehawken, New Jersey. Licensed in New Jersey. Registered with an NPI since 2021.

Licensed in
NJ
In the registry since
2021
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Practice location Address checks out

36 Hudson Pl
Weehawken, NJ 07086-7013
Phone: (201) 522-6474
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 40QA00655300 (NJ)

Record details

NPI number1356921118
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 14, 2021
Last updated in NPPESApril 14, 2021
Certification dateApril 14, 2021
Mailing address36 Hudson Pl, Weehawken, NJ 07086-7013

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