Healthcare Provider Details
I. General information
NPI: 1528042082
Provider Name (Legal Business Name): REGIONAL PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/30/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
586 KEARNY AVE 2 FL
KEARNY NJ
07032-2806
US
IV. Provider business mailing address
586 KEARNY AVE 2 FL
KEARNY NJ
07032-2806
US
V. Phone/Fax
- Phone: 201-991-9272
- Fax: 201-991-1532
- Phone: 201-991-9272
- Fax: 201-991-1532
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ROBERT
F
LOOBY
Title or Position: PRESIDENT
Credential: PT
Phone: 201-991-9272