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General NPI Number Information
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NPI Number | 1861521536
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Entity Type | Organization
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Legal Business Name | CENTER FOR SPORTS MEDICINE & PHYSICAL THERAPY
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1300 MAIN AVE SUITE 3A
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City | CLIFTON
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State | NJ
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Zip | 07011-2244
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Country | US
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Telephone | 973-777-0934
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 MAIN AVE SUITE 3A
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City | CLIFTON
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State | NJ
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Zip | 07011-2244
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Country | US
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Telephone | 973-777-0934
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. SAMMY MASRI
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Credential | M.D.
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Telephone | 973-777-0934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25MA07567400
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License Number State | NJ
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