Organization
DYNAMIC CARE PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WARREN BORRES PT (PRESIDENT)
(201) 558-0808
Entity
Organization
Contact information
Practice address
1625 KENNEDY BLVD, NORTH BERGEN, NJ 07047-6302
(201) 558-0808
(201) 558-0877
Mailing address
43 GREYHOUND CT, KENDALL PARK, NJ 08824-1492
(201) 558-0808
(201) 558-0877
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00766400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
066705
MEDICARE PROVIDER NUMBER (INDIVIDUAL)
NJ
01
—
40QA00766400
NEW JERSEY PHYSICAL THERAPY LICENSE NUMBER
NJ
Enumeration date
08/11/2010
Last updated
08/11/2010
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