Healthcare Provider Details

I. General information

NPI: 1063014751
Provider Name (Legal Business Name): TWIN BORO PHYSICAL THERAPY ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2020
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 NARDONE PL
JERSEY CITY NJ
07306-3514
US

IV. Provider business mailing address

PO BOX 52402
PHOENIX AZ
85072-2402
US

V. Phone/Fax

Practice location:
  • Phone: 201-792-3840
  • Fax: 732-855-9755
Mailing address:
  • Phone: 732-855-9751
  • Fax: 732-855-9751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DALE YAKE
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 678-837-7176