NPIMap

Organization Active NPI

Sports Medicine Center of Bergen, PA

  • Physical Therapist
  • Mahwah, NJ
National Provider Identifier
1073995304
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SPORTS MEDICINE CENTER OF BERGEN, PA
Practice address
1019 Macarthur Blvd
Excel Orthopedic Rehabilitation
Mahwah, NJ 07430
Phone
(201) 818-8711
Fax
(201) 818-8744
NPI assigned
Jun 23, 2015
Organization subpart
Yes
Parent organization
SPORTS PHYSICAL THERAPY CENTER OF BERGEN, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 24, 2016

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

Authorized official

Name
Mr. Gary Flink, P.T.
Title
Vice President
Phone
(201) 488-0488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1019 Macarthur Blvd
Excel Orthopedic Rehabilitation
Mahwah, NJ 07430

Mailing address

605 Main Street
Excel Orthopedic Rehabilitation
Hackensack, NJ 07601
Phone (201) 488-0488

Other names 1

  • Excel Orthopedic Rehabilitation Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Excel Orthopedic Rehabi8 organizations share this tax ID, including this one
Part of
Excel Orthopedic Rehabi

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464048000000",
    "number": "1073995304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 MAIN STREET",
            "address_2": "EXCEL ORTHOPEDIC REHABILITATION",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "07601",
            "telephone_number": "201-488-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 MACARTHUR BLVD",
            "address_2": "EXCEL ORTHOPEDIC REHABILITATION",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "07430",
            "telephone_number": "201-818-8711",
            "fax_number": "201-818-8744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MEDICINE CENTER OF BERGEN, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPORTS PHYSICAL THERAPY CENTER OF BERGEN, PA",
        "enumeration_date": "2015-06-23",
        "last_updated": "2016-05-24",
        "status": "A",
        "authorized_official_last_name": "FLINK",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "201-488-0488",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excel Orthopedic Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mahwah, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; 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.