1588767487 NPI number — FLANNERY PHYSICAL THERAPY LIMITED PARTNERSHIP

Table of content: (NPI 1588767487)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588767487 NPI number — FLANNERY PHYSICAL THERAPY LIMITED PARTNERSHIP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FLANNERY PHYSICAL THERAPY LIMITED PARTNERSHIP
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:
6
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:
1588767487
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/08/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 ROUTE 57
Provider Second Line Business Mailing Address:
SUITE 1
Provider Business Mailing Address City Name:
PHILLIPSBURG
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08865
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-387-1277
Provider Business Mailing Address Fax Number:
908-387-1280

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1465 STATE HWY 31
Provider Second Line Business Practice Location Address:
3RD FLOOR
Provider Business Practice Location Address City Name:
ANNANDALE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-328-3300
Provider Business Practice Location Address Fax Number:
908-328-3268
Provider Enumeration Date:
09/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KING
Authorized Official First Name:
JANNA
Authorized Official Middle Name:
P.
Authorized Official Title or Position:
VP/AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
713-297-7000

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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