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Organization
TALARIA PHYSICAL THERAPY LLC
Active
Organization
TALARIA PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEMETRI E. DIMITRIADIS PT, DPT (OWNER)
(201) 588-6290
Entity
Organization
Contact information
Practice address
100 UNION AVE STE 200, CRESSKILL, NJ 07626-2137
(201) 588-6290
(201) 588-6059
Mailing address
56 JACKSON AVE, HAWORTH, NJ 07641-1450
(201) 588-6290
(201) 588-6059
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01409300
NJ
2251S0007X
Sports Physical Therapist
40QA01409300
NJ
2251X0800X
Orthopedic Physical Therapist
40QA01409300
NJ
261QP2000X
Physical Therapy Clinic/Center
40QA01409300
NJ
Other
Enumeration date
08/26/2017
Last updated
10/09/2024
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