Healthcare Provider Details

I. General information

NPI: 1245195700
Provider Name (Legal Business Name): GARDEN STATE THERAPY MANALAPAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 TENNENT RD
MANALAPAN NJ
07726-3127
US

IV. Provider business mailing address

711 TENNENT RD
MANALAPAN NJ
07726-3127
US

V. Phone/Fax

Practice location:
  • Phone: 732-414-6060
  • Fax: 732-782-8182
Mailing address:
  • Phone: 732-414-6060
  • Fax: 732-782-8182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: NOAH MILLER
Title or Position: OWNER
Credential:
Phone: 908-415-5414