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Organization
MFS PHYSICAL THERAPY ASSISTIVE TECHNOLOGY P.C.
Active
Organization
MFS PHYSICAL THERAPY ASSISTIVE TECHNOLOGY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARICRIS FORMOSO-SANTOS PT, ATP (PHYSICAL THERAPIST)
(646) 918-4670
Entity
Organization
Contact information
Practice address
9-11 WESTMORELAND AVE, FAIR LAWN, NJ 07410-1923
(646) 918-4670
Mailing address
9-11 WESTMORELAND AVE, FAIR LAWN, NJ 07410-1923
(646) 918-4670
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
028196
NY
225100000X
Physical Therapist
Primary
40QA01313000
NJ
225CA2400X
Assistive Technology Practitioner Rehabilitation Counselor
—
—
Other
Enumeration date
12/17/2014
Last updated
02/08/2021
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