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NPI Code Detail

MEDICARE: ACTIVE MOTION PHYSICAL THERAPY PC

MEDICARE: ACTIVE MOTION PHYSICAL THERAPY PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1932505815
Entity Type Code : Organization
Provider Name (Legal Business Name) : ACTIVE MOTION PHYSICAL THERAPY PC
Provider Business Mailing Address
First Line : 710 MILL ST
Second Line : H3
City : BELLEVILLE
State : NJ
Zip : 07109-5318
Country : US
Telephone Number : 973-759-1494
Fax Number : 973-759-0557
Provider Business Practice Location Address
First Line : 799 MORRIS PARK AVE
Second Line :
City : BRONX
State : NY
Zip : 10462-3604
Country : US
Telephone Number : 855-465-7626
Fax Number :
Authorized Official
Title or Position : CEO
Name : DR. RICHARD HOLSMAN
Credential : DPT
Telephone Number : 973-393-5545
Provider Enumeration Date : 11/05/2014
Last Update Date : 11/05/2014

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Directions to “ACTIVE MOTION PHYSICAL THERAPY PC ” Practice Location

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