Total Body Wellness Center Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA00520400 Issued in NJ

Legal business name

TOTAL BODY WELLNESS CENTER INC

Practice address

250 Old River Rd
Edgewater, NJ 07020

Phone

(201) 945-4414

Fax

(201) 945-4412

NPI assigned

Mar 22, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Larry Shiera

Title

Owner

Phone

(201) 945-4414

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1154448579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 OLD RIVER ROAD",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "07020",
            "telephone_number": "201-945-4414",
            "fax_number": "201-945-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 OLD RIVER RD",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "07020",
            "telephone_number": "201-945-4414",
            "fax_number": "201-945-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL BODY WELLNESS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "SHIERA",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-945-4414",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00520400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Edgewater, NJ
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; 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.