Organization
TRANSFORMATIVE PHYSICAL THERAPY & WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUNNY THAKKAR PT (CEO)
(212) 227-3233
Entity
Organization
Contact information
Practice address
901 AVENUE C, BAYONNE, NJ 07002-3012
(212) 227-3233
(866) 549-5687
Mailing address
45 RIVER DR S APT 203, JERSEY CITY, NJ 07310-3701
(212) 227-3233
(866) 549-5687
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40QA01588700
STATE LICENSE
NJ
Enumeration date
04/24/2020
Last updated
04/29/2020
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