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General NPI Number Information
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NPI Number | 1669917464
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Entity Type | Organization
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Legal Business Name | SPORTSMED OF PARAMUS PA
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Dates
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Enumeration Date | 01/03/2017
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Last Update Date | 01/03/2017
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Provider Practice Location Address
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Address Line | 21 S SPRING VALLEY RD
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City | PARAMUS
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State | NJ
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Zip | 07652-2624
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Country | US
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Telephone | 201-362-2289
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Fax |
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Provider Business Mailing Address
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Address Line | 21 S SPRING VALLEY RD
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City | PARAMUS
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State | NJ
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Zip | 07652-2624
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Country | US
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Telephone | 201-362-2289
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF BILLING
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Name | CAROL AZAR
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Credential | RN
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Telephone | 201-362-2289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #3
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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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