Healthcare Provider Details

I. General information

NPI: 1750926861
Provider Name (Legal Business Name): OBJECTIVE PHYSICAL THERAPY & REHAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2019
Last Update Date: 11/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1081 PAULISON AVE
CLIFTON NJ
07011-3658
US

IV. Provider business mailing address

1081 PAULISON AVE
CLIFTON NJ
07011-3658
US

V. Phone/Fax

Practice location:
  • Phone: 732-678-6359
  • Fax:
Mailing address:
  • Phone: 732-678-6359
  • 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: GEETA PATEL
Title or Position: OWNER
Credential:
Phone: 732-678-6359