Organization
BACK TO FUNCTION HOME PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK D ZAMEROWSKI MPT, MBA (OWNER)
(856) 904-5361
Entity
Organization
Contact information
Practice address
49 SAILFISH DR, BRIGANTINE, NJ 08203-1347
(856) 904-5361
Mailing address
837 N 2ND ST APT 304, PHILADELPHIA, PA 19123-3031
(856) 904-5361
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
40QA00700300
NJ
261QP2000X
Physical Therapy Clinic/Center
Primary
PT010623L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
143586
MEDICARE PTAN
PA
01
—
152995
MEDICARE PTAN
NJ
Enumeration date
11/02/2008
Last updated
10/22/2009
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