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Organization
PHYSICAL THERAPY SPORTS REHAB
Active
Organization
PHYSICAL THERAPY SPORTS REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY JO BRONSON PT (DIRECTOR OF PHYSICAL THERAPY)
(732) 636-5151
Entity
Organization
Contact information
Practice address
585 MAIN ST, WOODBRIDGE, NJ 07095-1104
(732) 636-5151
(732) 602-0046
Mailing address
585 MAIN ST, WOODBRIDGE, NJ 07095-1104
(732) 636-5151
(732) 602-0046
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0120701
CIGNA OPEN ACCESS PLUS
NJ
01
—
3K4352
HEALTHNET
NJ
01
—
A495698
OXFORD
NJ
01
—
Q0W961
ORTHONET EMPIRE BC
NJ
Enumeration date
01/10/2007
Last updated
07/21/2022
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