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General NPI Number Information
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NPI Number | 1811181811
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Entity Type | Organization
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Legal Business Name | GOHEWEC PHYSIO-MED LINK, INC.
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Dates
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Enumeration Date | 09/02/2007
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 40 UNION AVE SUITE 105
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City | IRVINGTON
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State | NJ
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Zip | 07111-3277
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Country | US
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Telephone | 973-736-8990
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Fax |
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Provider Business Mailing Address
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Address Line | 75 WALKER RD
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City | WEST ORANGE
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State | NJ
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Zip | 07052-4436
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Country | US
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Telephone | 973-736-8990
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Fax |
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Authorized Official
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Title or Position | ASS. DIRECTOR
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Name | YEMI FEMI-AKANBI
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Credential | PT
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Telephone | 973-736-8990
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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 | 40QA00919700
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License Number State | NJ
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