Organization
OPTIMAL FORM & FUNCTION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL FORMISANO DPT (OWNER)
(201) 887-2409
Entity
Organization
Contact information
Practice address
1029 TEANECK RD STE 2E, TEANECK, NJ 07666-4514
(201) 887-2409
Mailing address
3-18 VIRGINIA DR, FAIR LAWN, NJ 07410-4727
(201) 887-2409
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
12/16/2024
Last updated
12/16/2024
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