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General NPI Number Information
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NPI Number | 1659689131
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Entity Type | Organization
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Legal Business Name | NEW ERA ORTHOPEDIC & SPORTS PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 09/19/2010
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Last Update Date | 09/19/2010
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Provider Practice Location Address
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Address Line | 40 UNION AVE SUITE 304
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City | IRVINGTON
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State | NJ
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Zip | 07111-3277
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Country | US
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Telephone | 973-416-4800
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Fax | 973-416-4801
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Provider Business Mailing Address
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Address Line | 40 UNION AVE SUITE 304
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City | IRVINGTON
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State | NJ
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Zip | 07111-3277
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Country | US
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Telephone | 973-416-4800
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Fax | 973-416-4801
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Authorized Official
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Title or Position | OWNER
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Name | ANTHONY OKEKE
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Credential | PT
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Telephone | 973-416-4800
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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 | 40QA0590500
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License Number State | NJ
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