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General NPI Number Information
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NPI Number | 1619558590
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Entity Type | Organization
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Legal Business Name | AMP PERFORMANCE REHAB LLC
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Dates
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Enumeration Date | 04/21/2021
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Last Update Date | 04/21/2021
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Provider Practice Location Address
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Address Line | 787 TABOR RD
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City | MORRIS PLAINS
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State | NJ
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Zip | 07950-2731
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Country | US
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Telephone | 862-251-2631
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Fax | 973-370-0699
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Provider Business Mailing Address
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Address Line | 787 TABOR RD
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City | MORRIS PLAINS
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State | NJ
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Zip | 07950-2731
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Country | US
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Telephone | 862-251-2631
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Fax | 973-370-0699
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | SHAUN ASTORGA
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Credential | P.T.
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Telephone | 862-251-2631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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