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Organization
PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY OF NJ, LLC
Active
Organization
PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY OF NJ, LLC
Active
Parent organization
PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, P.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, P.C.
Authorized official
MS. KATHLEEN BRUSH (CREDENTIALING MANAGER)
(718) 819-6805
Entity
Organization
Contact information
Practice address
440 OLD HOOK RD, EMERSON, NJ 07630-2302
(201) 497-6752
(201) 497-6756
Mailing address
576 BROADHOLLOW RD, MELVILLE, NY 11747-5002
(516) 321-2400
(516) 321-2401
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
255015
MEDICARE GROUP PTAN
NJ
Enumeration date
07/28/2014
Last updated
03/28/2018
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