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General NPI Number Information
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NPI Number | 1629897426
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Entity Type | Organization
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Legal Business Name | 505 PHYSICAL THERAPY
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Dates
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Enumeration Date | 10/08/2024
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 505 ROUTE 18
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City | E BRUNSWICK
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State | NJ
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Zip | 08816-2468
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Country | US
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Telephone | 201-936-0170
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Fax | 908-248-8466
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Provider Business Mailing Address
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Address Line | 505 ROUTE 18
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City | E BRUNSWICK
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State | NJ
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Zip | 08816-2468
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Country | US
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Telephone | 201-936-0170
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Fax | 908-248-8466
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Authorized Official
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Title or Position | ADMIN
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Name | PEGGY BAFFOE
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Credential |
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Telephone | 201-936-0170
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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 |
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License Number State |
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