Healthcare Provider Details

I. General information

NPI: 1154418374
Provider Name (Legal Business Name): HEALING HANDS THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2006
Last Update Date: 03/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CEDAR ST
GARWOOD NJ
07027-1107
US

IV. Provider business mailing address

200 CEDAR ST
GARWOOD NJ
07027-1107
US

V. Phone/Fax

Practice location:
  • Phone: 908-577-1857
  • Fax:
Mailing address:
  • Phone: 908-577-1857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA00822300
License Number StateNJ

VIII. Authorized Official

Name: EWA BIANCO
Title or Position: SINGLE MEMBER
Credential: PHYSICAL THERAPIST
Phone: 908-577-1857