MEDICARE: WAYNE ORTHOPEDIC PHYSICAL THERAPY, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1114250057
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WAYNE ORTHOPEDIC PHYSICAL THERAPY, PC

Provider Business Mailing Address
First Line	:	450 HAMBURG TPKE
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-8480
Country	:	US
Telephone Number	:	973-934-8150
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 HAMBURG TPKE
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-8480
Country	:	US
Telephone Number	:	973-934-8150
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BENJAMIN MEIR BURTON
Credential	:
Telephone Number	:	973-706-7620

Provider Enumeration Date	:	09/10/2009
Last Update Date	:	10/31/2020

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