MEDICARE: KATALYST PERFORMANCE 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	225X00000X	Occupational Therapist
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1902414915
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KATALYST PERFORMANCE AND REHABILITATION LLC

Provider Business Mailing Address
First Line	:	41 MOUNTAIN AVE
Second Line	:
City	:	HAWTHORNE
State	:	NJ
Zip	:	07506-3331
Country	:	US
Telephone Number	:	973-513-2120
Fax Number	:

Provider Business Practice Location Address
First Line	:	41 MOUNTAIN AVE
Second Line	:
City	:	HAWTHORNE
State	:	NJ
Zip	:	07506-3331
Country	:	US
Telephone Number	:	973-513-2120
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	SCOTT KONINGSWOOD
Credential	:	PT, DPT
Telephone Number	:	973-513-2120

Provider Enumeration Date	:	07/15/2020
Last Update Date	:	03/27/2024

Similar Medicare Providers

1376546218 — MS. SHELLEY C STEINBERG MSW, LCSW, LMFT
Practice Location Address:

35 MOUNTAIN AVE
HAWTHORNE, NJ
07506-3331

Practice Phone: 973-427-7867
Practice Fax: 973-427-1862

1912958521 — DR. SURENDRA P GOEL M.D.
Practice Location Address:

159 MOUNTAIN AVE
HAWTHORNE, NJ
07506-3331

Practice Phone: 973-557-6731
Practice Fax:

1982656518 — DR. VIJAY GOEL M.D.
Practice Location Address:

159 MOUNTAIN AVE
HAWTHORNE, NJ
07506-3331

Practice Phone: 973-557-6731
Practice Fax:

1790022556 — DR. MARIE LOUISE MANNINO M.D.
Practice Location Address:

91 MOUNTAIN AVE
HAWTHORNE, NJ
07506-3331

Practice Phone: 973-423-3534
Practice Fax:

1952304008 — WILPAGE INC.
Practice Location Address:

146 GENEVIEVE AVE
HAWTHORNE, NJ
07506-2332

Practice Phone: 973-423-4100
Practice Fax: 973-423-0715

1053316539 — MRS. KUSUM L KANSAL RD,CDE
Practice Location Address:

332 LAFAYETTE AVE
HAWTHORNE, NJ
07506-2506

Practice Phone: 973-460-7560
Practice Fax: 862-239-6059

Directions to “KATALYST PERFORMANCE AND REHABILITATION LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.