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General NPI Number Information
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NPI Number | 1174060891
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Entity Type | Organization
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Legal Business Name | HEALING PHYSICAL THERAPY
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Dates
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Enumeration Date | 01/20/2017
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Last Update Date | 01/20/2017
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Provider Practice Location Address
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Address Line | 451 MINE BROOK RD
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City | BERNARDSVILLE
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State | NJ
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Zip | 07924-2007
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Country | US
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Telephone | 201-469-5562
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Fax |
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Provider Business Mailing Address
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Address Line | 451 MINE BROOK RD
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City | BERNARDSVILLE
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State | NJ
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Zip | 07924-2007
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Country | US
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Telephone | 201-469-5562
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Fax |
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Authorized Official
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Title or Position | PT OWNER
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Name | MRS. MEHRBANOO MEHRROSTAMI
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Credential | PT
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Telephone | 201-793-8988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 40QA01526400
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License Number State | NJ
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