Garden State Physical Therapy and Wellness Center LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

40QA00504100 Issued in NJ

Legal business name

GARDEN STATE PHYSICAL THERAPY AND WELLNESS CENTER LLC

Practice address

700 N Broad St Ste 102
Elizabeth, NJ 07208-2310

Phone

(908) 354-1511

Fax

(908) 659-9229

NPI assigned

Feb 7, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Olfea Digamon Mangle, P.T.

Title

President

Phone

(908) 354-1511

Specialties & licenses 1

Addresses

Other identifiers 8

Locations

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1093855322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N BROAD ST STE 102",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072082310",
            "telephone_number": "908-354-1511",
            "fax_number": "908-659-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N BROAD ST STE 102",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072082310",
            "telephone_number": "908-354-1511",
            "fax_number": "908-659-9229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN STATE PHYSICAL THERAPY AND WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "MANGLE",
        "authorized_official_first_name": "OLFEA",
        "authorized_official_middle_name": "DIGAMON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-354-1511",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NJ",
            "license": "40QA00504100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "001590204",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3K4126",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3440262",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "Q23Q61",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS/BS",
            "identifier": "Q23Q61",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0000-225-0032-04",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN GROUP",
            "identifier": "687933",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORTHONET",
            "identifier": "44902",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cesar Garcia, MD
• Flor De Maria Garcia
• Kelly Garcia
• Yubisley Garcia
• Garden State Cardiovascular Specialists P.C
• Anshu Goyal Garg, M.D.
• Shubham Garg, MD
• Vipin Garg, M.D.
• Benedict Nagar Garma, MD
• Alize Y Garner

• Physical Therapy Clinic/Center in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Physical Therapy Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.