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

Trevor Fennell

Individual provider Physical Therapist · NPI 1619904125

Trevor Fennell is a Physical Therapist in Private Practice in Ridgewood, New Jersey. Qualified in 2000, 26 years ago. Accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
26
Licensed in
NJ
In the registry since
2006
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Practice location Address checks out

127 Union St Ste 105
Ridgewood, NJ 07450-4478
Phone: (201) 444-4447
Fax: (201) 444-5101
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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 40QA00907400 (NJ)

Record details

NPI number1619904125
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 28, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Ridgewood