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General NPI Number Information
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NPI Number | 1386843522
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Entity Type | Organization
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Legal Business Name | SYNERGY SPORTS AND MEDICAL REHABILITATION
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 12/09/2014
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Provider Practice Location Address
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Address Line | 6120 BUCHANAN PLACE
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City | WEST NEW YORK
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State | NJ
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Zip | 07093-2915
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Country | US
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Telephone | 201-758-5238
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Fax | 201-758-5240
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Provider Business Mailing Address
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Address Line | P.O. BOX 4073
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City | WEST NEW YORK
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State | NJ
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Zip | 07093-2915
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Country | US
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Telephone | 201-758-5238
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Fax | 201-758-5240
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | VIVIAN RODRIGUEZ
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Credential |
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Telephone | 201-758-5238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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