=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841860772
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STEP AHEAD HOME CARE PHYSICAL THERAPY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/01/2021
-----------------------------------------------------
Last Update Date | 07/01/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 914 LAWRENCEVILLE RD
-----------------------------------------------------
City | PRINCETON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08540-4320
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-933-6966
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 718
-----------------------------------------------------
City | MILLTOWN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08850-0718
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-933-6966
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OPERATIONAL MANAGER
-----------------------------------------------------
Name | DR. BETH J ROTHMAN
-----------------------------------------------------
Credential | PT, DPT
-----------------------------------------------------
Telephone | 609-933-6966
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------