Healthcare Provider Details

I. General information

NPI: 1861430357
Provider Name (Legal Business Name): THERAWORKS PHYSICAL THERAPY AND REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 FREEDOM HILLS DR
BARNEGAT NJ
08005-1829
US

IV. Provider business mailing address

PO BOX 324
BARNEGAT NJ
08005-0324
US

V. Phone/Fax

Practice location:
  • Phone: 732-290-2299
  • Fax: 732-749-8429
Mailing address:
  • Phone: 732-290-2299
  • Fax: 732-749-8429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA01134700
License Number StateNJ

VIII. Authorized Official

Name: ELEAZAR A SARES
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 732-290-2299