Healthcare Provider Details

I. General information

NPI: 1730776444
Provider Name (Legal Business Name): THE R3FINERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2020
Last Update Date: 12/29/2020
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 SUMMIT AVE # 303
SUMMIT NJ
07901-3633
US

IV. Provider business mailing address

95 SUMMIT AVE # 303
SUMMIT NJ
07901-3633
US

V. Phone/Fax

Practice location:
  • Phone: 908-263-7398
  • Fax:
Mailing address:
  • Phone: 908-263-7398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEXANDRA TERPOS
Title or Position: CO-OWNER
Credential: DPT
Phone: 908-263-7398