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NPI Code Detail

MEDICARE: THERAPHYSICAL, LLC

MEDICARE: THERAPHYSICAL, 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
1261QP2000XPhysical Therapy Clinic/Center40QA01383800NJ

General Provider Information

NPI Number : 1134463235
Entity Type Code : Organization
Provider Name (Legal Business Name) : THERAPHYSICAL, LLC
Provider Business Mailing Address
First Line : 623 RIDGE RD
Second Line :
City : LYNDHURST
State : NJ
Zip : 07071-3205
Country : US
Telephone Number : 201-340-4656
Fax Number : 201-340-4580
Provider Business Practice Location Address
First Line : 623 RIDGE RD
Second Line :
City : LYNDHURST
State : NJ
Zip : 07071-3205
Country : US
Telephone Number : 201-340-4656
Fax Number : 201-340-4580
Authorized Official
Title or Position : DPT
Name : DR. MAGDALENA BUCZEK
Credential :
Telephone Number : 201-340-4656
Provider Enumeration Date : 11/15/2012
Last Update Date : 08/20/2020

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