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General NPI Number Information
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NPI Number | 1063572758
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Entity Type | Organization
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Legal Business Name | ALPHA PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 07/24/2007
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Provider Practice Location Address
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Address Line | 1088 MAIN AVE
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City | CLIFTON
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State | NJ
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Zip | 07011
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Country | US
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Telephone | 973-778-5300
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Fax | 973-778-5678
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Provider Business Mailing Address
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Address Line | 1088 MAIN AVENUE
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City | CLIFTON
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State | NJ
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Zip | 07011
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Country | US
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Telephone | 973-778-5300
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Fax | 973-778-5678
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Authorized Official
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Title or Position | OWNER
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Name | PETER ANTONIOU
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Credential |
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Telephone | 973-778-5300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 0400133940
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License Number State | NJ
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