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General NPI Number Information
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NPI Number | 1407128440
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY INSTITUTE OF PATERSON
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Dates
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Enumeration Date | 02/07/2012
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Last Update Date | 02/07/2012
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Provider Practice Location Address
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Address Line | 586 E 27TH ST
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City | PATERSON
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State | NJ
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Zip | 07504-1922
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Country | US
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Telephone | 973-553-1704
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Fax | 973-742-6664
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Provider Business Mailing Address
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Address Line | 586 E 27TH ST
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City | PATERSON
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State | NJ
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Zip | 07504-1922
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Country | US
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Telephone | 973-553-1704
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Fax | 973-742-6664
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRETT WAYNE GEWANT
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Credential | D.C.
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Telephone | 201-286-4331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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