Organization
CEDARS THERAPY, LLC
Active
Other names
Cedars Therapy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. IRENE MIZOBE CONNOLLY PT, MS (DIRECTOR)
(609) 922-0814
Entity
Organization
Contact information
Practice address
45 N 3RD ST, PHILADELPHIA, PA 19106-4508
(609) 922-0814
Mailing address
51 N 3RD ST # 302, PHILADELPHIA, PA 19106-4517
(609) 922-0814
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT006318L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
145254
PROVIDER TRANSACTION ACCESS NUMBER GROUP
NJ
01
—
148676ZCSX
MEDICARE GROUP MEMBER NUMBER OR INDIVIDUAL PROVIDER TRANSACTION ACCESS NUMBER
NJ
01
—
PT006318L
PHYSICAL THERAPY LICEN
PA
Enumeration date
12/08/2006
Last updated
03/15/2012
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