Organization
SHAPE UP THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER GUTTMAN (DIRECTOR)
(917) 676-6426
Entity
Organization
Contact information
Practice address
35 WATERVIEW DR, LAKEWOOD, NJ 08701-4312
(917) 676-6426
Mailing address
35 WATERVIEW DR, LAKEWOOD, NJ 08701-4312
(917) 676-6426
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
—
—
252Y00000X
Early Intervention Provider Agency
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
09/18/2019
Last updated
09/18/2019
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