=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790967917
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADVANCED PHYSICAL THERAPY OF CENTRAL JERSEY, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/29/2007
-----------------------------------------------------
Last Update Date | 01/13/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 74 ROUTE 9 NORTH
-----------------------------------------------------
City | ENGLISHTOWN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07726
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-972-9233
-----------------------------------------------------
Fax | 732-972-8570
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 74 ROUTE 9 NORTH
-----------------------------------------------------
City | ENGLISHTOWN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07726
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-972-9233
-----------------------------------------------------
Fax | 732-972-8570
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICAL THERAPIST
-----------------------------------------------------
Name | HAZEL TAJANLANGIT
-----------------------------------------------------
Credential | PT
-----------------------------------------------------
Telephone | 732-972-9233
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number | 40QA00679000
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------