Pediatric Home PT LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PEDIATRIC HOME PT LLC

Practice address

6 Alexander CT
Jersey City, NJ 07305-5514

Phone

(201) 401-0702

Fax

(201) 685-7879

NPI assigned

May 4, 2018

Last updated

May 4, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amir Tadros

Title

Owner

Phone

(201) 401-0702

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1525392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525392000000",
    "number": "1619466612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 ALEXANDER CT",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073055514",
            "telephone_number": "201-401-0702",
            "fax_number": "201-685-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 ALEXANDER CT",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073055514",
            "telephone_number": "201-401-0702",
            "fax_number": "201-685-7879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC HOME PT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-04",
        "last_updated": "2018-05-04",
        "status": "A",
        "authorized_official_last_name": "TADROS",
        "authorized_official_first_name": "AMIR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-401-0702"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Pechter
• Kalyan Chakravarthi Peddineni
• Jill Ann Pedersen, LICSW
• Pedi Practices
• Pediatric Clinic of North Jersey
• Pediatric Practice
• Pediatric Therapy Resources, LLC
• Pediatrics A1, LLC
• Deborah Pedoeem
• Victoria S Pedoeem, D.D.S.

• Physical Therapy Clinic/Center in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Physical Therapy Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.