Organization
PROVERE PHYSICAL THERAPY - PARAMUS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CEDRIC HADDAD (CO-OWNER)
(201) 538-7131
Entity
Organization
Contact information
Practice address
407 SETTE DR BLDG E, PARAMUS, NJ 07652-2940
(201) 538-7131
(201) 538-7131
Mailing address
637 WYCKOFF AVE PMB 361, WYCKOFF, NJ 07481-1438
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
07/17/2017
Last updated
07/17/2017
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