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General NPI Number Information
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NPI Number | 1316278500
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Entity Type | Organization
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Legal Business Name | TEANECK PHYSICAL THERAPY AND PAIN MANAGEMENT INC
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Dates
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Enumeration Date | 01/27/2010
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Last Update Date | 01/27/2010
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Provider Practice Location Address
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Address Line | 1182 TEANECK RD SUITE 103
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City | TEANECK
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State | NJ
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Zip | 07666-4824
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Country | US
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Telephone | 862-215-2159
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Fax |
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Provider Business Mailing Address
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Address Line | 46 MEMPHIS AVE
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City | BELLEVILLE
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State | NJ
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Zip | 07109-1939
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Country | US
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Telephone | 862-215-2159
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | SYLBERT AMIL
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Credential | PT
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Telephone | 862-215-2159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | PT4OQA0921200
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License Number State | NJ
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