MEDICARE: FOUNDATIONS 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
1	261QP2000X	Physical Therapy Clinic/Center	40QA01133100	NJ

General Provider Information

NPI Number	:	1477970150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOUNDATIONS PHYSICAL THERAPY, LLC

Provider Business Mailing Address
First Line	:	273 PASCACK RD
Second Line	:	UNIT 285
City	:	TOWNSHIP OF WASHINGTON
State	:	NJ
Zip	:	07676-4809
Country	:	US
Telephone Number	:	201-527-7819
Fax Number	:

Provider Business Practice Location Address
First Line	:	273 PASCACK RD
Second Line	:	UNIT 285
City	:	TOWNSHIP OF WASHINGTON
State	:	NJ
Zip	:	07676-4809
Country	:	US
Telephone Number	:	201-527-7819
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST/ OWNER
Name	:	LAUREN SBARBARO
Credential	:	DPT
Telephone Number	:	201-527-7819

Provider Enumeration Date	:	03/19/2014
Last Update Date	:	03/19/2014

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