Individual provider Active NPI

Lauren Resnick, DPT

  • Physical Therapist
  • Whiting, NJ
National Provider Identifier
1437547973
Registry record updated Jan 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01084200 Issued in NJ
Practice address
67 Lacey Rd
Suites 8-12
Whiting, NJ 08759-2912
Phone
(732) 849-0080
NPI assigned
Jan 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01084200 NJ Primary

Addresses

Primary practice location

67 Lacey Rd
Suites 8-12
Whiting, NJ 08759-2912

Mailing address

67 Lacey Rd
Suites 8-12
Whiting, NJ 08759-2912
Phone (732) 849-0080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150210000530 NJ Practitioner - Physical Therapist in Private Practice 2466777610 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01084200NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Esd PT OT & SLP PLLC Physical Therapist CurrentSince Feb 15, 2023 Accepting new patients
At Home by Enhance Therapies LLC Physical Therapist CurrentSince Aug 19, 2022 Accepting new patients
Ivyrehab Network Inc. Physical Therapist Past Accepting new patients

Locations

411 Hackensack Ave
Ste 200
Hackensack, NJ 07601
Phone (732) 987-3833

400 Route 70
Lakewood, NJ 08701
Phone (609) 805-1686

2632 Atlantic Ave
Brooklyn, NY 11207
Phone (718) 473-3803

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1420588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420588800000",
    "number": "1437547973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 LACEY RD",
            "address_2": "SUITES 8-12",
            "city": "WHITING",
            "state": "NJ",
            "postal_code": "087592912",
            "telephone_number": "732-849-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 LACEY RD",
            "address_2": "SUITES 8-12",
            "city": "WHITING",
            "state": "NJ",
            "postal_code": "087592912",
            "telephone_number": "732-849-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESNICK",
        "first_name": "LAUREN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-07",
        "last_updated": "2015-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01084200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiting, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.