Organization
INNOVATIVE PHYSICAL THERAPY AND FITNESS CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SURESH BABU PT,DPT,MS (PRESIDENT)
(732) 853-8177
Entity
Organization
Contact information
Practice address
3562 ROUTE 27, SUITE 124, KENDALL PARK, NJ 08824
(732) 853-8177
Mailing address
3562 ROUTE 27, SUITE 124, KENDALL PARK, NJ 08824
(732) 853-8177
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
40QA01115800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180947DBD
MEDICARE
—
Enumeration date
04/26/2012
Last updated
05/12/2021
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