Organization
ESSENTIAL THERAPY SERVICES OF NJ
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IDOMENEE MEDY (DIRECTOR OF CLINICAL SERVICES)
(917) 499-8496
Entity
Organization
Contact information
Practice address
100 ENTERPRISE DR STE 301, ROCKAWAY, NJ 07866-2129
(602) 703-2801
(844) 800-1470
Mailing address
2703 MILBURN AVE, BALDWIN, NY 11510-4115
(917) 499-8496
(844) 800-1470
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
07/30/2021
Last updated
01/26/2022
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