MEDICARE: DOWNTOWN 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	2251X0800X	Orthopedic Physical Therapist	40QA01077000	NJ

General Provider Information

NPI Number	:	1801044565
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOWNTOWN PHYSICAL THERAPY, LLC

Provider Business Mailing Address
First Line	:	75 MONTGOMERY ST FL 603
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-3726
Country	:	US
Telephone Number	:	201-433-5483
Fax Number	:	201-433-1655

Provider Business Practice Location Address
First Line	:	75 MONTGOMERY ST FL 603
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-3726
Country	:	US
Telephone Number	:	201-433-5483
Fax Number	:	201-433-1655

Authorized Official
Title or Position	:	SINGLE MEMBER
Name	:	DAVID SYLVESTER
Credential	:
Telephone Number	:	201-433-5483

Provider Enumeration Date	:	09/05/2008
Last Update Date	:	09/05/2008

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