# ALL GARDEN STATE PHYSICAL THERAPY & SPORTS MEDICINE CENTER, INC.

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

## Provider details

- **NPI number:** 1679599294
- **Authorized official:** CARMEN E CHAPARRO (VICE PRESIDENT)
- **Authorized official phone:** (973) 345-1312

## Contact information

- **Practice address:** 750 BROADWAY, SUITE B, PATERSON, NJ 07514-1332
- **Practice address phone:** (973) 345-1312
- **Practice address fax:** (973) 742-0669
- **Mailing address:** 750 BROADWAY, SUITE B, PATERSON, NJ 07514-1332
- **Mailing address phone:** (973) 345-1312
- **Mailing address fax:** (973) 742-0669

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | QA04745 | NJ | Yes |

## Other

- **Enumeration date:** 07/15/2006
- **Last updated:** 09/05/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0026083 | AETNA | — |
| 01 | — | 1K7011 | HEALTH NET | — |