MGT Physical Therapy LLC

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

License

40QAO1259300 Issued in NJ

Legal business name

MGT PHYSICAL THERAPY LLC

Practice address

112 N Broadway Apt E
South Amboy, NJ 08879-1675

Phone

(732) 609-1547

NPI assigned

Oct 29, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Eduardo Mauricio Trujillo, DPTNPI 1881873966

Title

Physical Therapist

Phone

(732) 609-1547

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eduardo Mauricio Trujillo, DPT

  • Physical Therapist
  • Kenilworth, NJ
  • NPI 1881873966
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383004800000",
    "number": "1033547005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 N BROADWAY APT E",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088791675",
            "telephone_number": "732-609-1547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 N BROADWAY APT E",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088791675",
            "telephone_number": "732-609-1547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MGT PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-29",
        "last_updated": "2013-10-29",
        "status": "A",
        "authorized_official_last_name": "TRUJILLO",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_middle_name": "MAURICIO",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "732-609-1547",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "NJ",
            "license": "40QAO1259300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Disabilities Residential Treatment Facility in South Amboy, NJ
• Providers in South Amboy, NJ by specialty
• Physical Disabilities Residential Treatment Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; 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.