NPI 1104315811

Prime

Organisation Physical Therapist Newark, NJ

Practice location

Address: 60 Park Pl STE 402, Newark, NJ 07102-5513
Phone: (973) 803-8130
Mailing address: 32 Cypress St, Jersey City, NJ 07305-4869

Authorised official

Name: Mona Lisa Lao
Title: Operation Manager
Phone: (201) 936-2660

Registered specialties

Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X Licence 01062100 (NJ)

Other Physical Therapist providers in New Jersey →

Registry record

NPI: 1104315811
Entity type: Organization
NPI issued: 8 May 2018
Record last updated: 8 May 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.