Healthcare Provider Details

I. General information

NPI: 1780043620
Provider Name (Legal Business Name): LAO & CHENG PHYISCAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2016
Last Update Date: 02/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 CYPRESS ST
JERSEY CITY NJ
07305-4869
US

IV. Provider business mailing address

32 CYPRESS ST
JERSEY CITY NJ
07305-4869
US

V. Phone/Fax

Practice location:
  • Phone: 201-936-2660
  • Fax:
Mailing address:
  • Phone: 201-936-2660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number01062100
License Number StateNJ

VIII. Authorized Official

Name: MONA LISA LAO
Title or Position: PHYSICAL THERAPIST
Credential: P.T.
Phone: 201-936-2660