Organization
CORE BASICS PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOTAZ EBEIDO (CEO)
(201) 300-9897
Entity
Organization
Contact information
Practice address
255 W SPRING VALLEY AVE, SUITE 109, MAYWOOD, NJ 07607-1445
(201) 300-9897
Mailing address
255 W SPRING VALLEY AVE, SUITE 109, MAYWOOD, NJ 07607-1445
(201) 300-9897
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01713200
NJ
Other
Enumeration date
03/07/2017
Last updated
03/07/2017
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