1881839603 NPI number — NORTHERN HILLS PHYSICAL THERAPY, LLC

Table of content: ROGELIO ARJONA JR. PHARMACY TECHNICIAN (NPI 1508135807)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881839603 NPI number — NORTHERN HILLS PHYSICAL THERAPY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTHERN HILLS PHYSICAL THERAPY, LLC
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:
1881839603
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/08/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
272 ROUTE 206
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
FLANDERS
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07836-9081
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-927-3034
Provider Business Mailing Address Fax Number:
973-927-2853

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
272 ROUTE 206
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
FLANDERS
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07836-9081
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-927-3034
Provider Business Practice Location Address Fax Number:
973-927-2853
Provider Enumeration Date:
12/08/2008

Additional Information

Authorized Official

Authorized Official Last Name:
DECARO
Authorized Official First Name:
EILEEN
Authorized Official Middle Name:
CHRISTINE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
973-945-4160

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X , with the licence number:  40QA01253300 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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