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General NPI Number Information
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NPI Number | 1790338036
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Entity Type | Organization
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Legal Business Name | FUNCTIONALMAX CUSTOMIZED PHYSICAL THERAPY
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Dates
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Enumeration Date | 07/16/2019
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Last Update Date | 07/16/2019
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Provider Practice Location Address
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Address Line | 241 W PASSAIC ST APT 10B
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City | ROCHELLE PARK
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State | NJ
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Zip | 07662-3116
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Country | US
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Telephone | 646-388-4790
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Fax | 609-435-1234
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Provider Business Mailing Address
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Address Line | 241 W PASSAIC ST APT 10B
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City | ROCHELLE PARK
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State | NJ
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Zip | 07662-3116
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Country | US
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Telephone | 646-388-4790
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Fax | 609-435-1234
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | DR. MANUEL A ARRUFFAT
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Credential | PT DPT
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Telephone | 201-293-0753
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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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