Healthcare Provider Details

I. General information

NPI: 1689878209
Provider Name (Legal Business Name): UNIVERSAL PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4539 US HIGHWAY 9
HOWELL NJ
07731-3380
US

IV. Provider business mailing address

4539 US HIGHWAY 9
HOWELL NJ
07731-3380
US

V. Phone/Fax

Practice location:
  • Phone: 732-901-5553
  • Fax: 732-901-1131
Mailing address:
  • Phone: 732-901-5553
  • Fax: 732-901-1131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number40QA01061800
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SHARYN GOLDSTEIN
Title or Position: MEMBER
Credential: MS PT
Phone: 732-901-5553