Four Corners Physical Therapy, LLC

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

40QA00951200 Issued in NJ

Legal business name

FOUR CORNERS PHYSICAL THERAPY, LLC

Practice address

17 Hanover Rd
Building 300
Florham Park, NJ 07932-1411

Phone

(973) 845-2592

Fax

(973) 845-2593

NPI assigned

Jan 5, 2007

Organization subpart

No

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

Authorized official

Name

Debra Goldman, P.T.

Title

Clinical Director

Phone

(973) 239-8889

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349827200000",
    "number": "1487702791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 HANOVER RD",
            "address_2": "BUILDING 300",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321411",
            "telephone_number": "973-845-2592",
            "fax_number": "973-845-2593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 HANOVER RD",
            "address_2": "BUILDING 300",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321411",
            "telephone_number": "973-845-2592",
            "fax_number": "973-845-2593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR CORNERS PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2012-10-10",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "973-239-8889",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NJ",
            "license": "40QA00951200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthopedic Physical Therapist in Florham Park, NJ
• Providers in Florham Park, NJ by specialty
• Orthopedic Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; 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.