Healthcare Provider Details
I. General information
NPI: 1326474081
Provider Name (Legal Business Name): PARAMUS ORTHOPEDIC PHYSICAL THERAPY, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/25/2013
Last Update Date: 09/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
28 FARVIEW TER
PARAMUS NJ
07652-2740
US
IV. Provider business mailing address
28 FARVIEW TER
PARAMUS NJ
07652-2740
US
V. Phone/Fax
- Phone: 201-880-9810
- Fax: 201-880-9812
- Phone: 201-880-9810
- Fax: 201-880-9812
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 | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: DR.
MEIR
BENJAMIN
BURTON
Title or Position: OWNER
Credential: PT, DPT
Phone: 201-880-9810