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General NPI Number Information
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NPI Number | 1700197563
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Entity Type | Organization
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Legal Business Name | NEW HORIZONS PHYSICAL THERAPY & LYMPHEDEMA CARE LLC
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Dates
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Enumeration Date | 06/27/2010
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Last Update Date | 08/07/2018
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Provider Practice Location Address
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Address Line | 620 TOWNE CENTRE DR
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902
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Country | US
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Telephone | 732-658-1896
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Fax | 732-790-0952
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Provider Business Mailing Address
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Address Line | 19 PARKSIDE DR
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902-1221
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Country | US
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Telephone | 732-297-2669
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MR. CHANDRASHEKHAR VYAS
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Credential |
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Telephone | 732-421-2061
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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 | 40QA00933100
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License Number State | NJ
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