NPIMap

Organization Active NPI

Maureen Broderick Wilhelm LPT PA

  • Physical Therapist
  • Millburn, NJ
National Provider Identifier
1114963063
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MAUREEN BRODERICK WILHELM LPT PA
Practice address
187 Millburn Ave
Suite 110
Millburn, NJ 07041
Phone
(973) 467-7976
Fax
(973) 467-7971
NPI assigned
Jun 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Maureen Broderick Wilhelm, PT
Title
President
Phone
(973) 467-7976

Specialties & licenses 1

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

Addresses

Primary practice location

187 Millburn Ave
Suite 110
Millburn, NJ 07041

Mailing address

187 Millburn Avenue
Suite 110
Millburn, NJ 07041
Phone (973) 467-7976

Other names 1

  • Sports Training Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

64 River Rd
Ste 1
East Hanover, NJ 07936
Phone (973) 428-1050

1069 Ringwood Ave
Ste 211
Haskell, NJ 07420
Phone (973) 467-7976

Practitioners & affiliated clinicians

Practitioners 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114963063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 MILLBURN AVENUE",
            "address_2": "SUITE 110",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "07041",
            "telephone_number": "973-467-7976",
            "fax_number": "973-467-7971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 MILLBURN AVE",
            "address_2": "SUITE 110",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "07041",
            "telephone_number": "973-467-7976",
            "fax_number": "973-467-7971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAUREEN BRODERICK WILHELM LPT PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILHELM",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_middle_name": "BRODERICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-467-7976",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sports Training Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Millburn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.