Summit Physical Therapy and Sports Care, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SUMMIT PHYSICAL THERAPY AND SPORTS CARE, LLC

Practice address

160 Summit Ave Ste 104
Montvale, NJ 07645-1750

Phone

(201) 627-0100

Fax

(201) 746-6652

NPI assigned

Jan 16, 2014

Organization subpart

No

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

Authorized official

Name

Ralph Desiderio, PT

Title

Managing Member

Phone

(201) 627-0100

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402876800000",
    "number": "1154743763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 SUMMIT AVE STE 104",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451750",
            "telephone_number": "201-627-0100",
            "fax_number": "201-746-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 SUMMIT AVE STE 104",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451750",
            "telephone_number": "201-627-0100",
            "fax_number": "201-746-6652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT PHYSICAL THERAPY AND SPORTS CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-16",
        "last_updated": "2014-06-16",
        "status": "A",
        "authorized_official_last_name": "DESIDERIO",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "201-627-0100",
        "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": []
}

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• Physical Therapist in Montvale, NJ
• Providers in Montvale, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.