MEDICARE: PRINCETON PHYSICAL THERAPY CENTER, 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	40QA00252600	NJ

General Provider Information

NPI Number	:	1770514432
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRINCETON PHYSICAL THERAPY CENTER, P.C.

Provider Business Mailing Address
First Line	:	601 EWING ST STE C2
Second Line	:
City	:	PRINCETON
State	:	NJ
Zip	:	08540-2756
Country	:	US
Telephone Number	:	609-497-2300
Fax Number	:	609-683-5615

Provider Business Practice Location Address
First Line	:	601 EWING ST STE C2
Second Line	:
City	:	PRINCETON
State	:	NJ
Zip	:	08540-2756
Country	:	US
Telephone Number	:	609-497-2300
Fax Number	:	609-683-5615

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. ZAHRA BEHESHTI
Credential	:	P.T.
Telephone Number	:	609-497-2300

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	02/18/2011

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