Healthcare Provider Details

I. General information

NPI: 1821329814
Provider Name (Legal Business Name): TOTAL BODY PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2010
Last Update Date: 01/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 RIVERSIDE AVE
LYNDHURST NJ
07071-2643
US

IV. Provider business mailing address

525 RIVERSIDE AVE
LYNDHURST NJ
07071-2643
US

V. Phone/Fax

Practice location:
  • Phone: 201-460-9069
  • Fax: 201-460-7595
Mailing address:
  • Phone: 201-460-9069
  • Fax: 201-460-7595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2251C2600X
TaxonomyCardiopulmonary Physical Therapist
License Number
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code2251H1300X
TaxonomyHuman Factors Physical Therapist
License Number
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number StateNJ
# 6
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number StateNJ
# 7
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number StateNJ
# 8
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number StateNJ
# 9
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNJ
# 10
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number
License Number StateNJ
# 11
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number StateNJ
# 12
Primary TaxonomyN
Taxonomy Code225XH1300X
TaxonomyHuman Factors Occupational Therapist
License Number
License Number StateNJ
# 13
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number
License Number StateNJ
# 14
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number StateNJ
# 15
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNJ

VIII. Authorized Official

Name: CARLA TURCOKIPIANI
Title or Position: MANAGING MEMBER-OWNER
Credential:
Phone: 201-460-9069