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Organization
OPTIMAL FORM & FUNCTION, LLC
Active
Organization
OPTIMAL FORM & FUNCTION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL FORMISANO PT, DPT, OCS (FOUNDER/PHYSICAL THERAPIST)
(201) 817-9976
Entity
Organization
Contact information
Practice address
1029 TEANECK RD STE 2E, TEANECK, NJ 07666-4514
(551) 246-9340
Mailing address
3-18 VIRGINIA DR APT A, FAIR LAWN, NJ 07410-4727
(201) 887-2409
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
225XH1200X
Hand Occupational Therapist
—
—
Other
Enumeration date
06/30/2023
Last updated
12/16/2023
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