Healthcare Provider Details

I. General information

NPI: 1881581585
Provider Name (Legal Business Name): ANTHONY RUA DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 STUYVESANT AVE
LYNDHURST NJ
07071-2620
US

IV. Provider business mailing address

38 FARMINGDALE RD
WAYNE NJ
07470-6420
US

V. Phone/Fax

Practice location:
  • Phone: 201-605-9927
  • Fax:
Mailing address:
  • Phone: 973-951-8560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA02340100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: