MEDICARE: CARESPECTRUM

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	:	1962233072
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARESPECTRUM

Provider Business Mailing Address
First Line	:	11 CARRIAGE CT
Second Line	:
City	:	EAST WINDSOR
State	:	NJ
Zip	:	08520-2841
Country	:	US
Telephone Number	:	201-660-2484
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 CARRIAGE CT
Second Line	:
City	:	EAST WINDSOR
State	:	NJ
Zip	:	08520-2841
Country	:	US
Telephone Number	:	201-660-2484
Fax Number	:

Authorized Official
Title or Position	:	CIO
Name	:	MR. DWIGHT VILLARISCO FAUSTINO
Credential	:	PT
Telephone Number	:	201-660-2484

Provider Enumeration Date	:	08/10/2024
Last Update Date	:	08/10/2024

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Directions to “CARESPECTRUM ” Practice Location

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