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General NPI Number Information
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NPI Number | 1952801474
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Entity Type | Organization
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Legal Business Name | MAHONEY PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 02/21/2018
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Last Update Date | 02/21/2018
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Provider Practice Location Address
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Address Line | 420 RIVER RD
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City | CHATHAM
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State | NJ
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Zip | 07928-1265
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Country | US
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Telephone | 908-758-3077
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Fax |
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Provider Business Mailing Address
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Address Line | 420 RIVER RD APT B4
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City | CHATHAM
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State | NJ
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Zip | 07928-1249
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | DR. TIMOTHY R. MAHONEY
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Credential | PT, DPT
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Telephone | 908-758-3077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 40QA01572900
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License Number State | NJ
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