Healthcare Provider Details

I. General information

NPI: 1609108828
Provider Name (Legal Business Name): LIFE IN MOTION PHYSICAL THERAPY AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2010
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

391 DANFORTH AVE
JERSEY CITY NJ
07305-1984
US

IV. Provider business mailing address

13 FAIRFAX DR
LIVINGSTON NJ
07039-2813
US

V. Phone/Fax

Practice location:
  • Phone: 201-360-0871
  • Fax:
Mailing address:
  • Phone: 201-360-0871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARIA C AGUILA
Title or Position: PHYSICAL THERAPIST, CO-OWNER
Credential:
Phone: 201-360-0871