Healthcare Provider Details

I. General information

NPI: 1023574514
Provider Name (Legal Business Name): HUMBLE CARE PHYSICAL THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2019
Last Update Date: 02/27/2020
Certification Date: 02/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 MONTGOMERY ST FL 501
JERSEY CITY NJ
07302-3726
US

IV. Provider business mailing address

701 NEWARK AVE STE 212
ELIZABETH NJ
07208-3560
US

V. Phone/Fax

Practice location:
  • Phone: 201-433-6001
  • Fax: 201-433-6634
Mailing address:
  • Phone: 908-527-6001
  • Fax: 908-527-6634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JAMES PUMARADA
Title or Position: PHYSICAL THERAPIST/ PRESIDENT
Credential: DPT
Phone: 908-527-6001