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General NPI Number Information
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NPI Number | 1851196208
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Entity Type | Organization
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Legal Business Name | THERAFLEX PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 02/18/2025
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 749 MARIN AVE # 1
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City | LYNDHURST
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State | NJ
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Zip | 07071-2521
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Country | US
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Telephone | 201-916-1681
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Fax |
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Provider Business Mailing Address
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Address Line | 749 MARIN AVE # 1
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City | LYNDHURST
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State | NJ
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Zip | 07071-2521
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Country | US
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Telephone | 201-916-1681
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Fax |
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Authorized Official
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Title or Position | OWNER, AUTHORIZED OFFICIAL, PROVIDE
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Name | NATHANAEL PARK
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Credential | P.T.A.
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Telephone | 201-916-1681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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