# EDGE PHYSICAL THERAPY AND SPORTS MEDICINE LLC

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

## Provider details

- **NPI number:** 1558737395
- **Authorized official:** LAWRENCE KIM PT, DPT, OCS (MANAGING DIRECTOR)
- **Authorized official phone:** (201) 482-9523

## Contact information

- **Practice address:** 16 ARCADIAN WAY, SUITE C6, PARAMUS, NJ 07652-1291
- **Practice address phone:** (201) 483-9523
- **Practice address fax:** (201) 483-9534
- **Mailing address:** 16 ARCADIAN WAY, SUITE C6, PARAMUS, NJ 07652-1291

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 40QA01510100 | NJ | Yes |

## Other

- **Enumeration date:** 08/17/2015
- **Last updated:** 06/28/2016