Sports Medicine Center of Bergen, PA

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SPORTS MEDICINE CENTER OF BERGEN, PA

Practice address

216 Old Tappan Road, Suite 56-58D
Old Tappan, NJ 07675

Phone

(201) 781-5700

NPI assigned

Feb 1, 2017

Organization subpart

No

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

Authorized official

Name

Gary Flink, PT

Title

Owner

Phone

(201) 488-0488

Specialties & licenses 1

Addresses

Other names 1

• Excel Orthopedic Rehabilitation Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mayck A Calle Moran

  • Physical Therapist
  • Rutherford, NJ
  • NPI 1881559250
  NPD (past)
• Joseph J Camisa, PT, DPT

  • Physical Therapist
  • Morris Plains, NJ
  • NPI 1326349812
  NPD (past)

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

{
    "created_epoch": "1485907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485907200000",
    "number": "1477091270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 MAIN ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076015914",
            "telephone_number": "201-488-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 OLD TAPPAN ROAD, SUITE 56-58D",
            "city": "OLD TAPPAN",
            "state": "NJ",
            "postal_code": "07675",
            "telephone_number": "201-781-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MEDICINE CENTER OF BERGEN, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-01",
        "last_updated": "2017-02-01",
        "status": "A",
        "authorized_official_last_name": "FLINK",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-488-0488",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excel Orthopedic Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sensory Diagnostics and Pain Management Associates
• Loanda Ana Sota, PHARMD
• Spectrum Physical Therapy & Athletic Training, LLC
• Spectrum Wellness Center
• Spero E Demoleas
• James Steindl
• Jenna Stuebe, PT, DPT
• Sunhee Lee DMD PA
• SZR Old Tappan Assisted Living, LLC
• Nancy Kaplan Tancer, M.D.

• Physical Therapist in Old Tappan, NJ
• Providers in Old Tappan, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; 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.