Dynamic Physical Therapy and Wellness Center, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA00530700 Issued in NJ

Legal business name

DYNAMIC PHYSICAL THERAPY AND WELLNESS CENTER, LLC

Practice address

35 S Washington Ave
Bergenfield, NJ 07621-2399

Phone

(201) 385-1200

Fax

(201) 385-1206

NPI assigned

Nov 14, 2013

Last updated

Nov 14, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Danilo Oporto Cabusas, P.T.

Title

Secretary

Phone

(201) 637-1183

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

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.

• Alain Santos

  • Physical Therapist
  • East Elmhurst, NY
  • NPI 1043580962

  NJ

  Medicare reassignment NPD

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

{
    "created_epoch": "1384387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384387200000",
    "number": "1184054082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 S WASHINGTON AVE",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076212399",
            "telephone_number": "201-385-1200",
            "fax_number": "201-385-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 S WASHINGTON AVE",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076212399",
            "telephone_number": "201-385-1200",
            "fax_number": "201-385-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC PHYSICAL THERAPY AND WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-14",
        "last_updated": "2013-11-14",
        "status": "A",
        "authorized_official_last_name": "CABUSAS",
        "authorized_official_first_name": "DANILO",
        "authorized_official_middle_name": "OPORTO",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "201-637-1183",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00530700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr George Freed and Dr Jeffrey Gliksman
• Dr. Mark H. Jaffe
• Chanel L Dupree
• Maria Emma Mismanos Duquette, PTA
• Allison Dwyer
• E&E Speech Therapy Inc
• Jithin Sam Easo
• Eat Mostly Greens
• Jose Dennis Ecal, PT, DPT
• Eihab Human Services New Jersey, Inc.

• Physical Therapist in Bergenfield, NJ
• Providers in Bergenfield, 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 Nov 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.