Sports Medicine Center of Bergen, PA

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

Legal business name

SPORTS MEDICINE CENTER OF BERGEN, PA

Practice address

136 Hopper Ave.
Waldwick, NJ 07463

Phone

(201) 488-0488

NPI assigned

Apr 22, 2008

Organization subpart

No

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

Addresses

Other identifiers 1

Other names 1

• Excel Orthopedic Rehabilitation Doing business as

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464048000000",
    "number": "1154595197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 HOPPER AVE.",
            "city": "WALDWICK",
            "state": "NJ",
            "postal_code": "07463",
            "telephone_number": "201-488-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 HOPPER AVE.",
            "city": "WALDWICK",
            "state": "NJ",
            "postal_code": "07463",
            "telephone_number": "201-488-0488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MEDICINE CENTER OF BERGEN, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "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": "2251S0007X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEGACY",
            "identifier": "044081",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excel Orthopedic Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jonathan Smith, M.D.
• Michael Lloyd Smith Jr., APN
• Sinok Song
• Philip A. Sorabella, M.D.
• Speech Therapy Partners LLC
• Stacey Markowitz Hecht, MD, PA
• Julene Stassou, MS, RD
• Marissa Stellacci, PHARMD
• Stephen a. Jones, L.L.C.
• David Martin Strassberg

• Sports Physical Therapist in Waldwick, NJ
• Providers in Waldwick, NJ by specialty
• Sports Physical Therapist in New Jersey

• 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.