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General NPI Number Information
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NPI Number | 1952276792
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Entity Type | Organization
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Legal Business Name | NATIONAL PHYSIATRY, LLC
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Dates
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Enumeration Date | 10/10/2025
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 2201 BAY AVE
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City | OCEAN CITY
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State | NJ
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Zip | 08226-2568
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Country | US
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Telephone | 305-775-1076
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Fax | 305-357-7391
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Provider Business Mailing Address
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Address Line | PO BOX 872
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City | AGOURA HILLS
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State | CA
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Zip | 91376-0872
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Country | US
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Telephone | 305-775-1076
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Fax | 305-357-7391
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | JAMES BLACK
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Credential |
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Telephone | 305-606-6489
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician 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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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