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General NPI Number Information
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NPI Number | 1477808921
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Entity Type | Organization
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Legal Business Name | CLIFTON THERAPHY AND SPORTS INJURY
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Dates
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Enumeration Date | 07/20/2012
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Last Update Date | 08/15/2013
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Provider Practice Location Address
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Address Line | 1555 MAIN AVE
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City | CLIFTON
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State | NJ
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Zip | 07011-2109
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Country | US
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Telephone | 973-894-3622
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Fax | 973-894-3625
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Provider Business Mailing Address
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Address Line | 1555 MAIN AVE
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City | CLIFTON
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State | NJ
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Zip | 07011-2109
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Country | US
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Telephone | 973-894-3622
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Fax | 973-894-3625
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Authorized Official
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Title or Position | OWNER
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Name | MR. ALDOU CINCO
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Credential |
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Telephone | 973-894-3622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01007300
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License Number State | NJ
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