MEDICARE: M&NTHERAPYLLC

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	:	1346985942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M&NTHERAPYLLC

Provider Business Mailing Address
First Line	:	899 PINES LAKE DR W
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-6107
Country	:	US
Telephone Number	:	201-744-5740
Fax Number	:

Provider Business Practice Location Address
First Line	:	899 PINES LAKE DR W
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-6107
Country	:	US
Telephone Number	:	201-744-5740
Fax Number	:

Authorized Official
Title or Position	:	PTA
Name	:	NICHOLAS SCAGLIONE
Credential	:	CEO, PTA
Telephone Number	:	201-744-5740

Provider Enumeration Date	:	04/28/2022
Last Update Date	:	09/16/2024

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Directions to “M&NTHERAPYLLC ” Practice Location

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