Organization Active NPI

Freedom Pediatric Therapy LLC

  • Early Intervention Provider Agency
  • Lakewood, NJ
National Provider Identifier
1225376148
Registry record updated Jan 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
FREEDOM PEDIATRIC THERAPY LLC
Practice address
310 2ND St
Lakewood, NJ 08701-3351
Phone
(732) 367-4569
Fax
(732) 367-3253
NPI assigned
Jan 28, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2013

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

Authorized official

Name
Ms. Sheva S Reisner
Title
Administrator
Phone
(732) 367-4569

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

310 2ND St
Lakewood, NJ 08701-3351

Mailing address

310 2ND St
Lakewood, NJ 08701-3351
Phone (732) 367-4569

National Provider Directory

National Provider Directory

Locations

310 2nd St
Lakewood, NJ 08701
Phone (732) 232-4828

NPI Registry JSON

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

{
    "created_epoch": "1359331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359331200000",
    "number": "1225376148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 2ND ST",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087013351",
            "telephone_number": "732-367-4569",
            "fax_number": "732-367-3253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 2ND ST",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087013351",
            "telephone_number": "732-367-4569",
            "fax_number": "732-367-3253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM PEDIATRIC THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-28",
        "last_updated": "2013-01-28",
        "status": "A",
        "authorized_official_last_name": "REISNER",
        "authorized_official_first_name": "SHEVA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "732-367-4569",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; 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.