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NPI Code Detail

MEDICARE: BERKELEY HEIGHTS PHYSICAL THERAPY, LLC

MEDICARE: BERKELEY HEIGHTS PHYSICAL THERAPY, LLC
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
12251X0800XOrthopedic Physical Therapist40QA00847100NJ

General Provider Information

NPI Number : 1134181209
Entity Type Code : Organization
Provider Name (Legal Business Name) : BERKELEY HEIGHTS PHYSICAL THERAPY, LLC
Provider Business Mailing Address
First Line : 415 SPRINGFIELD AVE
Second Line :
City : BERKELEY HEIGHTS
State : NJ
Zip : 07922-1108
Country : US
Telephone Number : 908-898-1950
Fax Number : 908-898-1960
Provider Business Practice Location Address
First Line : 415 SPRINGFIELD AVE
Second Line :
City : BERKELEY HEIGHTS
State : NJ
Zip : 07922-1108
Country : US
Telephone Number : 908-898-1950
Fax Number : 908-898-1960
Authorized Official
Title or Position : OWNER
Name : DR. JEFFREY FITZGERALD
Credential : DPT
Telephone Number : 908-898-1950
Provider Enumeration Date : 04/04/2006
Last Update Date : 11/20/2018

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