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General NPI Number Information
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NPI Number | 1205168457
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Entity Type | Organization
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Legal Business Name | GOLDMAN PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 02/12/2010
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Last Update Date | 07/30/2015
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Provider Practice Location Address
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Address Line | 20 NORDHOFF PL FL 2 THE GYM
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-4811
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Country | US
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Telephone | 201-567-9399
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Fax | 201-567-9394
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Provider Business Mailing Address
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Address Line | 20 NORDHOFF PL FL 2 THE GYM
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-4811
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Country | US
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Telephone | 201-567-9399
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Fax | 201-567-9394
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAVID V GOLDMAN
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Credential | MSPT
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Telephone | 646-321-2639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01155800
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License Number State | NJ
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