# HALEDON PHYSICAL THERAPY & SPORTS MEDICINE LLC

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

## Provider details

- **NPI number:** 1366682601
- **Authorized official:** MS. NADIA ALQUDAH (OWNER)
- **Authorized official phone:** (973) 689-6112

## Contact information

- **Practice address:** 401 HALEDON AVE, SUITE B, HALEDON, NJ 07508-1570
- **Practice address phone:** (973) 689-6112
- **Practice address fax:** (973) 689-6114
- **Mailing address:** 401 HALEDON AVE, SUITE B, HALEDON, NJ 07508-1570
- **Mailing address phone:** (973) 689-6112
- **Mailing address fax:** (973) 689-6114

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 40QA0099400 | NJ | Yes |

## Other

- **Enumeration date:** 02/26/2009
- **Last updated:** 04/25/2009