Healthcare Provider Details

I. General information

NPI: 1063297364
Provider Name (Legal Business Name): SHORE PHYSICAL THERAPY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 NAVESINK AVE APT 10
HIGHLANDS NJ
07732-1806
US

IV. Provider business mailing address

100 NAVESINK AVE APT 10
HIGHLANDS NJ
07732-1806
US

V. Phone/Fax

Practice location:
  • Phone: 908-489-8229
  • Fax:
Mailing address:
  • Phone: 908-489-8229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS RUANE
Title or Position: AUTHORIZED OFFICIAL
Credential: DPT
Phone: 732-708-6400