Beredo Physical Therapy and Wellness, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

40QA01002900 Issued in NJ

Legal business name

BEREDO PHYSICAL THERAPY AND WELLNESS, LLC

Practice address

267 Broadway
Bayonne, NJ 07002-2519

Phone

(201) 354-9580

Fax

(201) 354-9581

NPI assigned

Nov 11, 2013

Organization subpart

No

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

Authorized official

Name

Gary Beredo, RPT

Title

Physical Therapist/Ceo

Phone

(201) 354-9580

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1384128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384128000000",
    "number": "1457780421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070022519",
            "telephone_number": "201-354-9580",
            "fax_number": "201-354-9581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070022519",
            "telephone_number": "201-354-9580",
            "fax_number": "201-354-9581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEREDO PHYSICAL THERAPY AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-11",
        "last_updated": "2013-11-11",
        "status": "A",
        "authorized_official_last_name": "BEREDO",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/CEO",
        "authorized_official_telephone_number": "201-354-9580",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "40QA01002900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gaetane Bellamy, FNP-C
• Offer Ben-Arie, PA-C
• Peter Benanti, LCSW
• Jerlyn M Benejan
• Quintina Louise Benson, MD
• Gary Dennis O Beredo
• Jennifer Beredo, PT
• Erica Ann Bermudez, OTR/L
• Timothy Calca Bernardino, MD
• Liliya Besedina, M.D.

• Specialist in Bayonne, NJ
• Providers in Bayonne, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2013; 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.