Healthcare Provider Details
I. General information
NPI: 1205755725
Provider Name (Legal Business Name): MOMENTUM PERFORMANCE PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
613 RIDGE RD
MONMOUTH JUNCTION NJ
08852-2630
US
IV. Provider business mailing address
601 PITNEY DR APT 37
SPRING LAKE NJ
07762-2257
US
V. Phone/Fax
- Phone: 732-882-2852
- Fax:
- Phone: 732-882-2852
- Fax:
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:
ALEXANDER
LETO
Title or Position: CO-OWNER
Credential: PT, DPT, OCS, CSCS
Phone: 732-832-1576