Healthcare Provider Details

I. General information

NPI: 1992142012
Provider Name (Legal Business Name): ALL CARE PHYSICAL THERAPY AND SPORTS MEDICINE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2013
Last Update Date: 04/23/2020
Certification Date: 04/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 MAIN AVE STE 3
PASSAIC NJ
07055-8400
US

IV. Provider business mailing address

831 MAIN AVE STE 3
PASSAIC NJ
07055-8400
US

V. Phone/Fax

Practice location:
  • Phone: 973-955-2850
  • Fax: 973-955-2851
Mailing address:
  • Phone: 973-955-2850
  • Fax: 973-955-2851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNJ

VIII. Authorized Official

Name: MR. RONALD SALES
Title or Position: PRESIDENT
Credential: P.T.
Phone: 646-894-8371