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General NPI Number Information
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NPI Number | 1306193677
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Entity Type | Organization
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Legal Business Name | BASKING RIDGE PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 08/06/2012
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Last Update Date | 08/06/2012
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Provider Practice Location Address
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Address Line | 150 N FINLEY AVE
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City | BASKING RIDGE
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State | NJ
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Zip | 07920-1686
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Country | US
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Telephone | 908-340-4772
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Fax | 908-340-4774
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Provider Business Mailing Address
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Address Line | 150 N FINLEY AVE
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City | BASKING RIDGE
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State | NJ
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Zip | 07920-1686
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Country | US
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Telephone | 908-340-4772
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Fax | 908-340-4774
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARC F RICCARDI
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Credential | PT, DPT, OCS, SCS
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Telephone | 908-340-4772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 40QA00971700
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License Number State | NJ
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