Healthcare Provider Details

I. General information

NPI: 1639032931
Provider Name (Legal Business Name): FORTERA HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 04/12/2026
Certification Date: 04/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 COLUMBIA TPKE STE 102B
FLORHAM PARK NJ
07932-2193
US

IV. Provider business mailing address

123 COLUMBIA TPKE STE 102B
FLORHAM PARK NJ
07932-2193
US

V. Phone/Fax

Practice location:
  • Phone: 973-755-0190
  • Fax: 973-755-0191
Mailing address:
  • Phone: 973-755-0190
  • Fax: 973-755-0191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: TERRENCE WELSH
Title or Position: PHYSICIAN
Credential: MD
Phone: 973-755-0190