NPIMap

Organization Active NPI

Kimberly Physical Therapy & Rehabilitation

  • Physical Therapy Clinic/Center
  • Newark, NJ
National Provider Identifier
1578810289
Registry record updated Aug 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
40QA00520400 Issued in NJ
Legal business name
KIMBERLY PHYSICAL THERAPY & REHABILITATION
Practice address
1060 Broad St
Newark, NJ 07102-2397
Phone
(973) 558-5353
Fax
(973) 558-5355
NPI assigned
Aug 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2012

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

Authorized official

Name
Mr. Edilberto Orcullo Estomo Jr., PHYSICAL THERAPIST
Title
Owner
Phone
(201) 951-7534

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 40QA00520400 NJ Primary

Addresses

Primary practice location

1060 Broad St
Newark, NJ 07102-2397

Mailing address

770 River Rd
#29
Edgewater, NJ 07020-6600
Phone (201) 851-7534

National Provider Directory

National Provider Directory

Locations

770 River Rd
Unit 29
Edgewater, NJ 07020

NPI Registry JSON

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344816000000",
    "number": "1578810289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 RIVER RD",
            "address_2": "#29",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070206600",
            "telephone_number": "201-851-7534",
            "fax_number": "201-758-5095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 BROAD ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071022397",
            "telephone_number": "973-558-5353",
            "fax_number": "973-558-5355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY PHYSICAL THERAPY & REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-13",
        "last_updated": "2012-08-13",
        "status": "A",
        "authorized_official_last_name": "ESTOMO",
        "authorized_official_first_name": "EDILBERTO",
        "authorized_official_middle_name": "ORCULLO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-951-7534",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NJ",
            "license": "40QA00520400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.