# ADVANCED PHYSICAL MEDICINE & REHABILITATION, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114336138
- **Authorized official:** DR. DANIEL REIZIS PT, DPT (MANAGING MEMBER)
- **Authorized official phone:** (732) 894-9200

## Contact information

- **Practice address:** 1719 MAIN ST, LAKE COMO, NJ 07719-3097
- **Practice address phone:** (732) 894-9200
- **Practice address fax:** (732) 894-9202
- **Mailing address:** 1719 MAIN ST, LAKE COMO, NJ 07719-3097
- **Mailing address phone:** (732) 894-9200
- **Mailing address fax:** (732) 894-9202

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | 25MZ00090400 | NJ | Yes |

## Other

- **Enumeration date:** 08/04/2014
- **Last updated:** 08/04/2014