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General NPI Number Information
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NPI Number | 1215742200
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Entity Type | Organization
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Legal Business Name | PHYNAI THERAPY GROUP
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Dates
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Enumeration Date | 02/08/2025
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1107 MANTUA PIKE STE 720 #102
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City | MANTUA
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State | NJ
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Zip | 08051
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Country | US
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Telephone | 215-435-8392
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Fax |
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Provider Business Mailing Address
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Address Line | 1107 MANTUA PIKE STE 720 BOX 102
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City | MANTUA
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State | NJ
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Zip | 08051
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, THERAPIST
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Name | MR. WADE GARRETT GREENWALD
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Credential | LPC, MBA
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Telephone | 215-435-8392
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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