Healthcare Provider Details

I. General information

NPI: 1487750329
Provider Name (Legal Business Name): PROTHERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 BELVIDERE AVE
WASHINGTON NJ
07882-1451
US

IV. Provider business mailing address

37 BELVIDERE AVE
WASHINGTON NJ
07882-1451
US

V. Phone/Fax

Practice location:
  • Phone: 908-689-8500
  • Fax: 908-689-8500
Mailing address:
  • Phone: 908-689-8500
  • Fax: 908-689-8500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. MARCEL POULIOT
Title or Position: PRESIDENT
Credential:
Phone: 908-689-8500