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General NPI Number Information
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NPI Number | 1699320150
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Entity Type | Organization
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Legal Business Name | FAMILY PHYSICAL THERAPY OF RIDGEWOOD, L.L.C.
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Dates
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Enumeration Date | 08/01/2019
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Last Update Date | 08/01/2019
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Provider Practice Location Address
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Address Line | 310 N MAPLE AVE
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-2609
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Country | US
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Telephone | 201-447-3707
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Fax | 201-447-0320
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Provider Business Mailing Address
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Address Line | 310 N MAPLE AVE
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-2609
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Country | US
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Telephone | 201-447-3707
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Fax | 201-447-0320
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Authorized Official
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Title or Position | OWNER
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Name | DR. DR. KEVIN EMERY
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Credential | DC
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Telephone | 201-447-3707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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