MEDICARE: CROSS PHYSICAL THERAPY P C

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1659658854
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CROSS PHYSICAL THERAPY P C

Provider Business Mailing Address
First Line	:	100 CENTRAL AVE
Second Line	:	B4
City	:	FORT LEE
State	:	NJ
Zip	:	07024-7326
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 CENTRAL AVE
Second Line	:	B4
City	:	FORT LEE
State	:	NJ
Zip	:	07024-7326
Country	:	US
Telephone Number	:	646-220-5962
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR OF PHYSICAL THERAPY
Name	:	DR. ABRAHAM ABRAHAM
Credential	:	DPT
Telephone Number	:	646-220-5962

Provider Enumeration Date	:	11/16/2011
Last Update Date	:	11/16/2011

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