Healthcare Provider Details

I. General information

NPI: 1407637390
Provider Name (Legal Business Name): ENDGAME PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2023
Last Update Date: 01/01/2024
Certification Date: 01/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 NJ-10 WEST
SUCCASUNNA NJ
07876
US

IV. Provider business mailing address

27 SCHINDLER DR
ROCKAWAY NJ
07866-4800
US

V. Phone/Fax

Practice location:
  • Phone: 973-809-7435
  • Fax:
Mailing address:
  • Phone: 973-809-7435
  • Fax: 551-361-9176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW W FUNG
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: PT, DPT, OCS, CSCS
Phone: 973-809-7435