Healthcare Provider Details

I. General information

NPI: 1578525028
Provider Name (Legal Business Name): INSTITUTE OF PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 02/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 RIDGE RD
NORTH ARLINGTON NJ
07031
US

IV. Provider business mailing address

108 RIDGE RD
NORTH ARLINGTON NJ
07031
US

V. Phone/Fax

Practice location:
  • Phone: 201-997-3234
  • Fax: 201-997-3417
Mailing address:
  • Phone: 201-997-3234
  • Fax: 201-997-3417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MISS DIANE JANKIEWICZ
Title or Position: PHYSICAL THERAPIST OWNER
Credential: PT, DPT
Phone: 201-997-3234