Bergen Physical Therapy, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

BERGEN PHYSICAL THERAPY, LLC

Practice address

520 Main St
Fort Lee, NJ 07024-4501

Phone

(201) 947-7805

Fax

(201) 947-7806

NPI assigned

Jun 5, 2017

Last updated

Jun 5, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mario Glavicic, DCNPI 1659383578

Title

Owner

Phone

(201) 947-7805

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mario V Glavicic, DC

  • Chiropractor
  • Fort Lee, NJ
  • NPI 1659383578
  Medicare reassignment Care Compare group NPD Authorized official
• Peter Kofitsas, MS,PT

  • Physical Therapist
  • River Vale, NJ
  • NPI 1669622437
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496620800000",
    "number": "1013446954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MAIN ST",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244501",
            "telephone_number": "201-947-7805",
            "fax_number": "201-947-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MAIN ST",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244501",
            "telephone_number": "201-947-7805",
            "fax_number": "201-947-7806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERGEN PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-05",
        "last_updated": "2017-06-05",
        "status": "A",
        "authorized_official_last_name": "GLAVICIC",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-947-7805",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Igor Beregnoi, PHD, L.P.C
• Bergen Care Pharmacy Inc (Bergen Care Pharmacy)
• Bergen Foot & Ankle Group LLC
• Bergen Internal Medicine LLC
• Bergen Physical Therapy & Wellness, P.C.
• Bergen Psychological Services, LLC
• Emile Tobias Berk, PH.D.
• Steven Bernstein, D.P.M
• Best Care NJ LLC
• Best Home Care Inc

• Chiropractor in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.