Professional Orthopedic and Sports Physical Therapy of NJ, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY OF NJ, LLC

Practice address

1055 Hamburg Tpke
Wayne, NJ 07470-3235

Phone

(973) 305-0074

Fax

(973) 305-0074

NPI assigned

Jan 1, 2013

Last updated

Mar 29, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY PCAs reported in NPPES

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

Authorized official

Name

Helen Agrelo

Title

Executive Director of Business Ops

Phone

(718) 767-0610

Specialties & licenses 1

Addresses

Part of

Professional Orthopedic Sports PT

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

{
    "created_epoch": "1356998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1326384967",
    "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": "718-767-0610",
            "fax_number": "516-750-9076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 HAMBURG TPKE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074703235",
            "telephone_number": "973-305-0074",
            "fax_number": "973-305-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY OF NJ, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY PC",
        "enumeration_date": "2013-01-01",
        "last_updated": "2018-03-29",
        "status": "A",
        "authorized_official_last_name": "AGRELO",
        "authorized_official_first_name": "HELEN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF BUSINESS OPS",
        "authorized_official_telephone_number": "718-767-0610"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Wayne, NJ
• Providers in Wayne, 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 Mar 29, 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.