Organization
FIRST CLASS PHYSICAL THERAPY (NJ), PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAVEL KHROMCHENKO DPT (MEDICAL DIRECTOR)
(347) 462-4876
Entity
Organization
Contact information
Practice address
124 GREGORY AVE, PASSAIC, NJ 07055-4856
(347) 462-4876
Mailing address
11 HEDGEROW LN, MANALAPAN, NJ 07726-7905
(347) 462-4876
(347) 435-2111
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00840600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40QA00840600
NJ LICENSE NUMBER
NJ
Enumeration date
06/12/2013
Last updated
08/09/2013
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