Healthcare Provider Details

I. General information

NPI: 1437016177
Provider Name (Legal Business Name): PORTO PHYSICAL THERAPY & WELLNESS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 RARITAN RD STE 2
CLARK NJ
07066-1230
US

IV. Provider business mailing address

1445 RARITAN RD STE 2
CLARK NJ
07066-1230
US

V. Phone/Fax

Practice location:
  • Phone: 908-202-3417
  • Fax:
Mailing address:
  • Phone: 908-202-3417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALEX OLIVEIRA
Title or Position: DPT/PROVIDER
Credential: DPT
Phone: 305-801-9405