Silver Lake Physical Therapy of Randolph

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SILVER LAKE PHYSICAL THERAPY OF RANDOLPH

Practice address

1201 Sussex Tpke Ste 104
Randolph, NJ 07869-2974

Phone

(973) 933-2224

Fax

(973) 933-2618

NPI assigned

Apr 21, 2021

Organization subpart

No

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

Authorized official

Name

Marilyn Umali-Dizon, PT

Title

Administration

Phone

(973) 933-2224

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1518548437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 SUSSEX TPKE STE 104",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078692974",
            "telephone_number": "973-933-2224",
            "fax_number": "973-933-2618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 SUSSEX TPKE STE 104",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078692974",
            "telephone_number": "973-933-2224",
            "fax_number": "973-933-2618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVER LAKE PHYSICAL THERAPY OF RANDOLPH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A",
        "authorized_official_last_name": "UMALI-DIZON",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "ADMINISTRATION",
        "authorized_official_telephone_number": "973-933-2224",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nilam Shah, PHARMD
• Pallavi Devendra Shah, M.D.
• Kishwar Shareef, M.D.
• Elena Shteynberg, M.D.
• Nancy G. Shumate, LCSW
• David J Simon
• Michael David Singer, DMD
• Vileen Singh
• Robert Raymond Siroty, M.D.
• Skylands Center Offering Autism Programs, Inc.

• Physical Therapist in Randolph, NJ
• Providers in Randolph, 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 Apr 21, 2021; 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.