Dynamic Physical Therapy of New Jersey P.a.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01291900 Issued in NJ

Legal business name

DYNAMIC PHYSICAL THERAPY OF NEW JERSEY P.A.

Practice address

20 Thoreau Dr
Poets Square
Freehold, NJ 07728-4329

Phone

(732) 303-1425

Fax

(732) 780-7990

NPI assigned

Dec 17, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Christopher Anthony Bautista

Title

Practice Administrator

Phone

(914) 309-9564

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1418774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418774400000",
    "number": "1053719484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6248 80TH ST",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113791323",
            "telephone_number": "718-429-2888",
            "fax_number": "646-304-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 THOREAU DR",
            "address_2": "POETS SQUARE",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077284329",
            "telephone_number": "732-303-1425",
            "fax_number": "732-780-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC PHYSICAL THERAPY OF NEW JERSEY P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-17",
        "last_updated": "2014-12-17",
        "status": "A",
        "authorized_official_last_name": "BAUTISTA",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "914-309-9564",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01291900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Duke, ANPC
• Dungarvin New Jersey, LLC-Helen
• Rosemary Durnan, M.D.
• Patricia Durso, CRNA
• Dylhar LLC
• Agnieszka Dziubak
• E&M Communications LLC
• Ear Nose & Throat of Freehold LLC
• East Freehold Medical Group L.L.C.
• Glenn Easton, CO,BOCPO,LPO

• Physical Therapist in Freehold, NJ
• Providers in Freehold, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.