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Organization
ALL GARDEN STATE PHYSICAL THERAPY & SPORTS MEDICINE CENTER, INC.
Active
Organization
ALL GARDEN STATE PHYSICAL THERAPY & SPORTS MEDICINE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARMEN E CHAPARRO (VICE PRESIDENT)
(973) 345-1312
Entity
Organization
Contact information
Practice address
750 BROADWAY, SUITE B, PATERSON, NJ 07514-1332
(973) 345-1312
(973) 742-0669
Mailing address
750 BROADWAY, SUITE B, PATERSON, NJ 07514-1332
(973) 345-1312
(973) 742-0669
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
QA04745
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0026083
AETNA
—
01
—
1K7011
HEALTH NET
—
Enumeration date
07/15/2006
Last updated
09/05/2008
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