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General NPI Number Information
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NPI Number | 1598272783
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Entity Type | Organization
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Legal Business Name | ACTIVE NJ PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 01/09/2018
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 35 NEW STAR RIDGE ROAD
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City | SPARTA
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State | NJ
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Zip | 07871
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Country | US
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Telephone | 862-222-4528
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Fax |
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Provider Business Mailing Address
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Address Line | 35 NEW STAR RIDGE RD
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City | SPARTA
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State | NJ
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Zip | 07871-3000
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Country | US
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Telephone | 862-222-4528
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. NICK JAROMAHUM
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Credential | PT
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Telephone | 862-222-4528
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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 | 40QA0826300
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License Number State | NJ
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