Healthcare Provider Details

I. General information

NPI: 1205549557
Provider Name (Legal Business Name): HIGH POINT PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2023
Last Update Date: 01/03/2023
Certification Date: 01/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 PONDEROSA TRL
SPARTA NJ
07871-3229
US

IV. Provider business mailing address

13 PONDEROSA TRL
SPARTA NJ
07871-3229
US

V. Phone/Fax

Practice location:
  • Phone: 201-452-8703
  • Fax:
Mailing address:
  • Phone: 201-452-8703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MATTHEW ISAIAH SHOHEN
Title or Position: CEO
Credential:
Phone: 201-452-8703