NPIMap

Organization Active NPI

Advanced Physical Medicine & Rehabilitation, LLC

  • Acupuncturist
  • Lake Como, NJ
National Provider Identifier
1114336138
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
25MZ00090400 Issued in NJ
Legal business name
ADVANCED PHYSICAL MEDICINE & REHABILITATION, LLC
Practice address
1719 Main St
Lake Como, NJ 07719-3097
Phone
(732) 894-9200
Fax
(732) 894-9202
NPI assigned
Aug 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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

Authorized official

Name
Dr. Daniel Reizis, PT, DPTNPI 1174835755
Title
Managing Member
Phone
(732) 894-9200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X 25MZ00090400 NJ Primary

Addresses

Primary practice location

1719 Main St
Lake Como, NJ 07719-3097

Mailing address

1719 Main St
Lake Como, NJ 07719-3097
Phone (732) 894-9200

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407110400000",
    "number": "1114336138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 MAIN ST",
            "city": "LAKE COMO",
            "state": "NJ",
            "postal_code": "077193097",
            "telephone_number": "732-894-9200",
            "fax_number": "732-894-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1719 MAIN ST",
            "city": "LAKE COMO",
            "state": "NJ",
            "postal_code": "077193097",
            "telephone_number": "732-894-9200",
            "fax_number": "732-894-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PHYSICAL MEDICINE & REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-04",
        "last_updated": "2014-08-04",
        "status": "A",
        "authorized_official_last_name": "REIZIS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "732-894-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00090400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Como, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.