Create Your Core, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

CREATE YOUR CORE, LLC

Practice address

44 Lakeside Dr S
Piscataway, NJ 08854-5104

Phone

(908) 510-0290

NPI assigned

Sep 17, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Penn

Title

Physical Therapist

Phone

(908) 510-0290

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568678400000",
    "number": "1255981718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 LAKESIDE DR S",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088545104",
            "telephone_number": "908-510-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 LAKESIDE DR S",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088545104",
            "telephone_number": "908-510-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATE YOUR CORE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-17",
        "last_updated": "2019-09-17",
        "status": "A",
        "authorized_official_last_name": "PENN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "908-510-0290",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Matthew Crawford
• Creative Perspective
• Richard Creteau
• Adeline Criado
• Adriana D Crump
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• Physical Therapy Clinic/Center in Piscataway, NJ
• Providers in Piscataway, NJ by specialty
• Physical Therapy Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; 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.