MEDICARE: THERAWORKS PHYSICAL THERAPY AND REHABILITATION 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	225100000X	Physical Therapist	40QA01134700	NJ

General Provider Information

NPI Number	:	1861430357
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAWORKS PHYSICAL THERAPY AND REHABILITATION LLC

Provider Business Mailing Address
First Line	:	PO BOX 324
Second Line	:
City	:	BARNEGAT
State	:	NJ
Zip	:	08005-0324
Country	:	US
Telephone Number	:	732-290-2299
Fax Number	:	732-749-8429

Provider Business Practice Location Address
First Line	:	115 FREEDOM HILLS DR
Second Line	:
City	:	BARNEGAT
State	:	NJ
Zip	:	08005-1829
Country	:	US
Telephone Number	:	732-290-2299
Fax Number	:	732-749-8429

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	ELEAZAR A SARES
Credential	:
Telephone Number	:	732-290-2299

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	08/05/2024

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