NPIMap

Organization Active NPI

Professional Orthopedic and Sports Therapy of NJ, LLC

  • Physical Therapist
  • Fort Lee, NJ
National Provider Identifier
1205316528
Registry record updated Aug 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PROFESSIONAL ORTHOPEDIC AND SPORTS THERAPY OF NJ, LLC
Practice address
2200 Fletcher Ave Ste 505
Fort Lee, NJ 07024
Phone
(201) 849-5201
Fax
(201) 849-5014
NPI assigned
Aug 16, 2018
Last updated
Aug 16, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 16, 2018

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

Authorized official

Name
Kathleen Brush
Title
Credentialing Manager
Phone
(631) 359-5805

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

2200 Fletcher Ave Ste 505
Fort Lee, NJ 07024

Mailing address

576 Broadhollow Rd
Melville, NY 11747-5002
Phone (631) 359-5859

National Provider Directory

National Provider Directory
Tax ID family
Professional Orthopedic and Sports Physical Therapy of NJ LLC9 organizations share this tax ID, including this one
Part of
Professional Orthopedic Sports PT

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534377600000",
    "number": "1205316528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 FLETCHER AVE STE 505",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "07024",
            "telephone_number": "201-849-5201",
            "fax_number": "201-849-5014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ORTHOPEDIC AND SPORTS THERAPY OF NJ, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, P.C.",
        "enumeration_date": "2018-08-16",
        "last_updated": "2018-08-16",
        "status": "A",
        "authorized_official_last_name": "BRUSH",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "631-359-5805"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.