Healthcare Provider Details

I. General information

NPI: 1619133618
Provider Name (Legal Business Name): DB ORTHOPEDIC PHYSICAL THERAPY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2008
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 NEWMAN SPRINGS RD STE 308
RED BANK NJ
07701-5688
US

IV. Provider business mailing address

331 NEWMAN SPRINGS RD STE 308
RED BANK NJ
07701-5688
US

V. Phone/Fax

Practice location:
  • Phone: 732-747-1262
  • Fax: 732-747-1292
Mailing address:
  • Phone: 732-747-1262
  • Fax: 732-747-1292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number40QA00442600
License Number StateNJ

VIII. Authorized Official

Name: MR. DAVID BERTONE
Title or Position: PRESIDENT
Credential: PT
Phone: 732-747-1262