=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891668729
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THERAPHYSICAL LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/26/2025
-----------------------------------------------------
Last Update Date | 09/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 259 PATERSON AVE UNIT 4
-----------------------------------------------------
City | WALLINGTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07057
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-315-1106
-----------------------------------------------------
Fax | 973-315-1141
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 623 RIDGE ROAD
-----------------------------------------------------
City | LYNDHURST
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07071
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-340-4656
-----------------------------------------------------
Fax | 201-340-4580
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MAGDALENA BUCZEK
-----------------------------------------------------
Credential | DPT
-----------------------------------------------------
Telephone | 973-277-3911
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2251X0800X
-----------------------------------------------------
Taxonomy Name | Orthopedic Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------