MEDICARE: ATLANTIC PHYSICAL THERAPY CENTER

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	40QA08448	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0216601	OTHER	NJ	ORTHONET
2	2648936	OTHER	NJ	AETNA

General Provider Information

NPI Number	:	1801857917
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTIC PHYSICAL THERAPY CENTER

Provider Business Mailing Address
First Line	:	1372 ROUTE 9
Second Line	:	BUILDING # 2
City	:	TOMS RIVER
State	:	NJ
Zip	:	08755-4038
Country	:	US
Telephone Number	:	732-240-9296
Fax Number	:	732-240-9297

Provider Business Practice Location Address
First Line	:	1372 ROUTE 9
Second Line	:	BUILDING # 2
City	:	TOMS RIVER
State	:	NJ
Zip	:	08755-4038
Country	:	US
Telephone Number	:	732-240-9296
Fax Number	:	732-240-9297

Authorized Official
Title or Position	:	TREASURER
Name	:	MR. DAVID J MANZO
Credential	:
Telephone Number	:	732-240-9296

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	05/06/2013

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Directions to “ATLANTIC PHYSICAL THERAPY CENTER ” Practice Location

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