=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255089629
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HAPPINESS PHYSICAL THERAPY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/15/2022
-----------------------------------------------------
Last Update Date | 01/19/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 255 W SPRING VALLEY AVE STE 109
-----------------------------------------------------
City | MAYWOOD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07607-1444
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 224-410-6792
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3105 PINHORN DR
-----------------------------------------------------
City | BRIDGEWATER
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08807-3519
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 224-410-6792
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | AHMED ABOELSAAD
-----------------------------------------------------
Credential | DPT, OCS, CHT
-----------------------------------------------------
Telephone | 201-300-9897
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------