Organization
PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN BRUSH (CREDENTIALING COORDINATOR MANAGER)
(718) 819-6805
Entity
Organization
Contact information
Practice address
1 GREENWOOD AVE, MONTCLAIR, NJ 07042-3649
(973) 746-2424
(973) 746-5030
Mailing address
576 BROADHOLLOW RD, MELVILLE, NY 11747-5002
(631) 359-5859
(631) 396-0865
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
09/14/2016
Last updated
03/29/2018
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