# J&R PHYSICAL THERAPY, LLC

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

## Provider details

- **NPI number:** 1164528287
- **Authorized official:** ROGER RUDZINSKI P.T. (PARTNER)
- **Authorized official phone:** (201) 858-0786

## Contact information

- **Practice address:** 415 AVENUE A, BAYONNE, NJ 07002-1504
- **Practice address phone:** (201) 858-0786
- **Practice address fax:** (201) 858-0786
- **Mailing address:** 415 AVENUE A, BAYONNE, NJ 07002-1504
- **Mailing address phone:** (201) 858-0786

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 40QA00517500 | NJ | Yes |

## Other

- **Enumeration date:** 09/16/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2523576 | UNITED HEALTHCARE ID\# | NJ |
| 01 | — | DE9058 | RAILROAD MEDICARE GROUP \# | NJ |