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General NPI Number Information
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NPI Number | 1487678538
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Entity Type | Organization
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Legal Business Name | OPTIMUM ORTHOPEDICS PHYSICAL THERAPY AND REHABILITATION CENTER, LLC
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 10/04/2007
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Provider Practice Location Address
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Address Line | 70 RIDGE RD
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City | LYNDHURST
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State | NJ
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Zip | 07071-1216
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Country | US
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Telephone | 201-933-9959
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Fax | 201-933-9958
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Provider Business Mailing Address
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Address Line | 70 RIDGE RD
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City | LYNDHURST
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State | NJ
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Zip | 07071-1216
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Country | US
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Telephone | 201-933-9959
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Fax | 201-933-9958
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Authorized Official
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Title or Position | SR. OFFICE MANAGER
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Name | JENNIFER MARTIN
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Credential |
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Telephone | 973-746-2424
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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 |
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License Number State |
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