NPIMap

Organization Active NPI

Sportsmed Physical Therapy, LLC

  • Chiropractor
  • Franklin Lakes, NJ
National Provider Identifier
1356631717
Registry record updated Apr 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00313700 Issued in NJ
Legal business name
SPORTSMED PHYSICAL THERAPY, LLC
Practice address
784 Franklin Ave
Suite 230
Franklin Lakes, NJ 07417-1306
Phone
(201) 819-0090
Fax
(201) 819-0014
NPI assigned
Apr 19, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2011

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

Authorized official

Name
Albert Khalaf
Title
Member/Officer
Phone
(201) 803-7695

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 38MC00313700 NJ Primary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 38MC00630100 NJ
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 38MC00619200 NJ
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 40QA01154700 NJ

Addresses

Primary practice location

784 Franklin Ave
Suite 230
Franklin Lakes, NJ 07417-1306

Mailing address

784 Franklin Ave
Suite 230
Franklin Lakes, NJ 07417-1306
Phone (201) 819-0090

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303257600000",
    "number": "1356631717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "784 FRANKLIN AVE",
            "address_2": "SUITE 230",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074171306",
            "telephone_number": "201-819-0090",
            "fax_number": "201-819-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 FRANKLIN AVE",
            "address_2": "SUITE 230",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074171306",
            "telephone_number": "201-819-0090",
            "fax_number": "201-819-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTSMED PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-19",
        "last_updated": "2011-04-20",
        "status": "A",
        "authorized_official_last_name": "KHALAF",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "MEMBER/OFFICER",
        "authorized_official_telephone_number": "201-803-7695"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00313700",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00630100",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00619200",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01154700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin Lakes, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; 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.