MEDICARE: AIM 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	225100000X	Physical Therapist	40QA01051300	NJ

General Provider Information

NPI Number	:	1871694885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AIM PHYSICAL THERAPY, LLC

Provider Business Mailing Address
First Line	:	312 BELLEVILLE TPKE
Second Line	:	SUITE 2A
City	:	NORTH ARLINGTON
State	:	NJ
Zip	:	07031-6463
Country	:	US
Telephone Number	:	973-616-7117
Fax Number	:	973-616-7338

Provider Business Practice Location Address
First Line	:	312 BELLEVILLE TPKE
Second Line	:	SUITE 2A
City	:	NORTH ARLINGTON
State	:	NJ
Zip	:	07031-6463
Country	:	US
Telephone Number	:	973-616-7117
Fax Number	:	973-616-7338

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN ROMMER IGNACIO
Credential	:	PT
Telephone Number	:	973-616-7117

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	08/22/2020

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