Mattea Ad PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

MATTEA AD PC

Practice address

33-11 Broadway
Fair Lawn, NJ 07410-4634

Phone

(201) 791-6351

Fax

(201) 791-6007

NPI assigned

Nov 29, 2007

Organization subpart

No

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

Authorized official

Name

Mr. David Berenbaum, PTNPI 1932276219

Title

Physical Therapist

Phone

(201) 791-6351

Specialties & licenses 1

Addresses

Other names 1

• Center IMT Fair Lawn Doing business as

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.

• David Berenbaum, RPT

  • Physical Therapist
  • Fair Lawn, NJ
  • NPI 1932276219
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383782400000",
    "number": "1225210453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33-11 BROADWAY",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074104634",
            "telephone_number": "201-791-6351",
            "fax_number": "201-791-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33-11 BROADWAY",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074104634",
            "telephone_number": "201-791-6351",
            "fax_number": "201-791-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTEA AD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-29",
        "last_updated": "2013-11-07",
        "status": "A",
        "authorized_official_last_name": "BERENBAUM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "201-791-6351",
        "authorized_official_name_prefix": "Mr.",
        "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": [
        {
            "organization_name": "Center IMT Fair Lawn",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marvin Wisch PA
• Moiza M Maryam
• Laurel-Anne Lauretta Mason
• Jerise M. Massone, D.C.
• Daniel E Massoud, LMFT
• Maximized Living & Wellness Center, LLC
• Hannah Brooke Mayer
• Lisa Jane Mayo, BCBA
• Jennifer Patricia McAuley, LCSW
• Lucas John McCarren

• Physical Therapist in Fair Lawn, NJ
• Providers in Fair Lawn, 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 7, 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.