MEDICARE: SPECTRUM THERAPEUTICS OF NJ 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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1932644754
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECTRUM THERAPEUTICS OF NJ LLC

Provider Business Mailing Address
First Line	:	601 HAMBURG TPKE STE 103
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-2049
Country	:	US
Telephone Number	:	973-689-7123
Fax Number	:	973-840-7143

Provider Business Practice Location Address
First Line	:	601 HAMBURG TPKE STE 103
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-2049
Country	:	US
Telephone Number	:	973-689-7123
Fax Number	:	973-840-7143

Authorized Official
Title or Position	:	PT
Name	:	ROBERT LETIZIA
Credential	:
Telephone Number	:	973-595-6066

Provider Enumeration Date	:	01/03/2017
Last Update Date	:	01/28/2026

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