Organization
DYNAMIC PHYSICAL THERAPY AND SPORTS REHAB AT NEWARK
Active
Other names
Dynamic Physical Therapy and Sports Rehab at Newark
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER MERCADO (MANAGING PARTNER)
(201) 564-7515
Entity
Organization
Contact information
Practice address
495 N 13TH ST, NEWARK, NJ 07107-1317
(973) 991-0220
(973) 990-0221
Mailing address
220 LIVINGSTON ST STE 108, NORTHVALE, NJ 07647-1739
(201) 564-7515
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
02/04/2019
Last updated
05/16/2019
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