Minnella Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

40QA01021500 Issued in NJ

Legal business name

MINNELLA PHYSICAL THERAPY, LLC

Practice address

217 Buchanan Ave
Edgewater Park, NJ 08010-2109

Phone

(973) 919-4862

Fax

(866) 699-1796

NPI assigned

Feb 25, 2009

Last updated

Feb 25, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lewis M Minnella, PT, DPT

Title

Physical Therapist

Phone

(973) 919-4862

Specialties & licenses 1

Addresses

Other names 1

• Inertia Other name

Locations

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235520000000",
    "number": "1346480712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 BUCHANAN AVE",
            "city": "EDGEWATER PARK",
            "state": "NJ",
            "postal_code": "080102109",
            "telephone_number": "973-919-4862",
            "fax_number": "866-699-1796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 BUCHANAN AVE",
            "city": "EDGEWATER PARK",
            "state": "NJ",
            "postal_code": "080102109",
            "telephone_number": "973-919-4862",
            "fax_number": "866-699-1796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNELLA PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-25",
        "last_updated": "2009-02-25",
        "status": "A",
        "authorized_official_last_name": "MINNELLA",
        "authorized_official_first_name": "LEWIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "973-919-4862",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NJ",
            "license": "40QA01021500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Inertia",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Physical Therapy Clinic/Center in Edgewater Park, NJ
• Providers in Edgewater Park, 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 Feb 25, 2009; 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.