Eastern Monmouth Physical Therapy LLC
Organization Active NPI Physical Therapist · Ocean, NJ
NPI 1407050784 · NPPES record last updated Jun 30, 2022
Key facts
- NPI
- 1407050784
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- License
- QA0859400 (NJ)
- Legal business name
- EASTERN MONMOUTH PHYSICAL THERAPY LLC
- Practice address
- 301 Bingham Ave
Suite a
Ocean, NJ 07712-4764 - Phone
- (732) 922-6618
- Fax
- (732) 922-6619
- NPI assigned
- Jun 12, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Brian M Mullins, MS,PT
- Title
- Owner
- Phone
- (732) 922-6618
Practitioners 7
-
Brian Melvin Mullins, MS., PT
-
Matthew David Pecoraro, PT, DPT
-
Robert D Bazley, PT
-
Peter D Scalia, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050415000678 | NJ | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 1850338252 |
Receives reassigned benefits from 3 practitioners Practice locations: Ocean, NJ |
National Provider Directory
Locations
788 Wayside Rd
Neptune, NJ 07753
Phone (732) 922-6618
788 Wayside Rd
Ste A
Neptune, NJ 07753
Phone (732) 922-6618
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | QA0859400 | NJ | Yes |
Addresses
Primary practice location
301 Bingham Ave
Suite a
Ocean, NJ 07712-4764
Mailing address
301 Bingham Ave
Suite a
Ocean, NJ 07712-4764
Phone (732) 922-6618
Other providers in Ocean, NJ
- Danielle Nicole Drayton
- DRS. Eisenberg of Ocean, PA
- DRS. Gould, Henderson, Rogers, and Vaclavik LLC
- Alicia Durett
- Margaret Dwyer-Anderson
- Robert Francis Edelhauser
- Irving Edelsberg
- Joan Friedman Edelsberg
- Rebecca T Edelsberg
- Megan Edwards
All providers in Ocean, NJ · Physical Therapist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.