Professional Orthopedic and Sports Physical Therapy of NJ, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY OF NJ, LLC

Practice address

1 Greenwood Ave
Montclair, NJ 07042-3649

Phone

(973) 841-5519

Fax

(973) 746-5030

NPI assigned

Mar 18, 2016

Organization subpart

Yes

Parent organization

PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, P.C.As reported in NPPES

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

Authorized official

Name

Kathleen Brush

Title

Credentialing Manager

Phone

(718) 819-6805

Specialties & licenses 3

Addresses

Part of

Professional Orthopedic and Sports Physical Therapy PC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Professional Orthopedic and Sports Physical Therapy, P.C.

  • Physical Therapist
  • Montville, NJ
  • NPI 1700387966
  NPPES parent name

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

{
    "created_epoch": "1458259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522195200000",
    "number": "1528429545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5859",
            "fax_number": "631-396-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GREENWOOD AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423649",
            "telephone_number": "973-841-5519",
            "fax_number": "973-746-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY OF NJ, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, P.C.",
        "enumeration_date": "2016-03-18",
        "last_updated": "2018-03-28",
        "status": "A",
        "authorized_official_last_name": "BRUSH",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "718-819-6805"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Occupational & Physical Therapy, PLLC
• Professional Occupational & Physical Therapy, PLLC
• Professional Orthopedic and Sports Physical Therapy of NJ, LLC
• Progressive Health Care, LLC
• Jennifer Prost, LCSW (DE), LSW (NJ)
• Provere Physical Therapy - Montclair, LLC
• Pinky Pun, NP
• Crispino Punzalan, M.D.

• Physical Therapist in Montclair, NJ
• Providers in Montclair, 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 Mar 28, 2018; 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.