# HYBRID PT, LLC

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

## Provider details

- **NPI number:** 1952805392
- **Authorized official:** JAMES PARK (OWNER)
- **Authorized official phone:** (201) 429-3996

## Contact information

- **Practice address:** 962 KINDERKAMACK RD, RIVER EDGE, NJ 07661-2331
- **Practice address phone:** (201) 429-3996
- **Practice address fax:** (201) 812-9604
- **Mailing address:** 962 KINDERKAMACK ROAD, RIVER EDGE, NJ 07661-2331
- **Mailing address phone:** (201) 429-3996
- **Mailing address fax:** (201) 812-9604

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 40QA01252200 | NJ | Yes |

## Other

- **Enumeration date:** 03/21/2018
- **Last updated:** 02/07/2019