1528042082 NPI number — REGIONAL PHYSICAL THERAPY

Table of content: (NPI 1528042082)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528042082 NPI number — REGIONAL PHYSICAL THERAPY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REGIONAL PHYSICAL THERAPY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528042082
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
586 KEARNY AVE
Provider Second Line Business Mailing Address:
2 FL
Provider Business Mailing Address City Name:
KEARNY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07032-2806
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-991-9272
Provider Business Mailing Address Fax Number:
201-991-1532

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
586 KEARNY AVE
Provider Second Line Business Practice Location Address:
2 FL
Provider Business Practice Location Address City Name:
KEARNY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07032-2806
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-991-9272
Provider Business Practice Location Address Fax Number:
201-991-1532
Provider Enumeration Date:
11/30/2005

Additional Information

Authorized Official

Authorized Official Last Name:
LOOBY
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
F
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
201-991-9272

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1K9058 . This is a "HEALTH NET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 25201 . This is a "CIGNA (ORTHONET)" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com